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effective colon-oscopy. "The adoption of high-definition white light imaging let
us see the colon's surface in a more vivid way than in the past," he says. "For
example, we could see subtle, flat lesions on the right side of the colon."
As good as HD imaging (and the up-and-coming ultra high-definition resolu-
tion) is, it can only show physicians what's on the surface of the colon. The use
of electronic chromoendoscopy technologies, however, enables a view that the
human eye cannot naturally see.
These imaging options leverage the response of different kinds of tissue to dif-
ferent kinds of light in order to deliver a contrast-enhanced view of the mucosal
surface and the blood vessels beneath it — as well as subtle changes in tissue
and vascular patterns that may indicate pre-cancerous polyps — in real time.
"A change in the mucosal lining is a harbinger for malignant design," explains
Alexander Rosemurgy, MD, director of the Southeastern Center for Digestive
Disorders at Florida Hospital Tampa. "If we send down a particular band of
light, a certain wavelength, like green or blue light, we get a different penetra-
tion of tissue than with white light. Blood vessels are more visible, the structure
is more defined."
That's how Narrow Band Imaging technology, available in Olympus's scopes,
works. When the scope's white light is filtered down to specific color compo-
nents, the resulting illumination penetrates the mucosa and submucosa to effec-
tively highlight vasculature and lesion boundaries.
Other scope manufacturers' proprietary systems employ digital image post-
processing to provide the enhanced views. The software that powers Fujifilm's
FICE (Flexible Spectral Imaging Color Enhancement), Pentax's i-SCAN and
EndoChoice's recently announced Lumos Adaptive Matrix Imaging (currently
awaiting regulatory clearance and market launch for its Fuse scope) analyzes
white light images as they're sent to the video processor and selectively high-
lights specific wavelengths of reflected light and anatomical features.
