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Chromoendoscopy in magnetically guided capsule endoscopy

Please always quote using this URN: urn:nbn:de:bvb:29-opus-48152
  • Background Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study. Methods We propose a modified preparation protocol which adds a staining step to theBackground Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study. Methods We propose a modified preparation protocol which adds a staining step to the existing MGCE preparation protocol. An optimal staining concentration is quantitatively determined for different stain types and pathologies. To that end 190 pig stomach tissue samples with and without lesion imitations were stained with different dye concentrations. Quantitative visual criteria are introduced to measure the quality of the staining with respect to mucosa and lesion visibility. Thusly determined optimal concentrations are tested in an ex-vivo pig stomach experiment under magnetic guidance of an endoscopic capsule with the modified protocol. Results We found that the proposed protocol modification does not impact the visibility in the stomach or steerability of the endoscopy capsule. An average optimal staining concentration for the proposed protocol was found at 0.4% for Methylene blue and Indigo carmine. The lesion visibility is improved using the previously obtained optimal dye concentration. Conclusions We conclude that chromoendoscopy may be applied in MGCE and improves mucosa and lesion visibility. Systematic evaluation provides important information on appropriate staining concentration. However, further animal and human in-vivo studies are necessary.show moreshow less

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Metadaten
Author:Philip W. Mewes, Stefan Förtsch, Aleksandar Lj Juloski, Elli Angelopoulou, Stefan K. Gölder, Dirk M. Guldi, Joachim Hornegger, Helmut Messmann
Persistent identifiers - URN:urn:nbn:de:bvb:29-opus-48152
Document Type:Article
Language:English
Year of publication:2013
Publishing Institution:Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
Release Date:2013/07/09
Tag:Indigo carmine; Methylene blue; Staining
SWD-Keyword:-
Original publication:BioMedical Engineering OnLine 12.52 (2013): 01.07.2013 <http://www.biomedical-engineering-online.com/content/12/1/52>
Institutes:Naturwissenschaftliche Fakultät / Naturwissenschaftliche Fakultät -ohne weitere Spezifikation-
Dewey Decimal Classification:5 Naturwissenschaften und Mathematik / 50 Naturwissenschaften / 500 Naturwissenschaften und Mathematik
open_access (DINI-Set):open_access
Collections:Universität Erlangen-Nürnberg / Von der FAU geförderte Open Access Artikel / Von der FAU geförderte Open Access Artikel 2013