Advancement in UGI Endoscopy -Present and Future-

Advancement in UGI Endoscopy -Present and Future-

20 Aug 2021 17:40 18:05
(25 mins)
Seiichiro Abe Speaker
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Screening upper GI endoscopy plays an important role in improving the prognosis of gastric cancer. JGES guidelines recommend taking sufficient stomach inspection time and a systematic screening program to inspect the stomach entirely. White light image (WLI) is the current standard modality for screening endoscopy for gastric cancer. Despite the widespread use of high definition endoscope, some early gastric cancers can be missed even by expert endoscopists, particularly small and flat early gastric cancer. The false-negative rate, so-called early gastric cancer miss rate, was reported to be 4-25%. Further development of Image-enhanced endoscopy has been warranted to improve the quality of screening endoscopy. NBI is recommended to use as the standard modality to detect esophageal squamous cell carcinoma.
Recently, Olympus launched a new image processor EVIS X1. This EVIS X1 integrates a new image enhanced endoscopy, texture and color enhancement imaging. TXI aimed to enhance the visibility of suspicious areas during lesion detection, enhancing subtle surface elevation and depression, brightening dark areas without light reflection, and subtle color changes. A pilot study demonstrated that the color difference between non-neoplastic and neoplastic areas was significantly higher in TXI mode 1 than WLI. The visibility was improved in 35 % of lesions in TXI mode 1 compared with WLI. Brightness adjustment imaging with maintenance of contrast (BAI-MAC) can brighten the darer area, the distal side of the esophagus where the illumination can not reach.
EVIS X-1 is a new processor that provides clearer and higher resolution images than before, improving the quality of screening upper endoscopy. I believe that endoscopists worldwide can use a universal endoscopy system and discuss and develop collaboration with the same high-quality image in the future.
Large-scale clinical trials are warranted to investigate the performance of EVIS X-1 for real-time cancer detection.

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