Narrow band imaging under less-air condition improves the visibility of superficial esophageal squamous cell carcinoma
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RESEARCH ARTICLE
Open Access
Narrow band imaging under less‑air condition improves the visibility of superficial esophageal squamous cell carcinoma Taro Iwatsubo1,2, Ryu Ishihara1*, Yasushi Yamasaki3, Yusuke Tonai4, Kenta Hamada3, Minoru Kato5, Sho Suzuki6, Mitsuhiro Kono1, Hiromu Fukuda1, Yusaku Shimamoto1, Kentaro Nakagawa1, Masayasu Ohmori1, Masamichi Arao1,7, Kenshi Matsuno1, Hiroyoshi Iwagami1, Shuntaro Inoue1, Hiroko Nakahira1, Noriko Matsuura1, Satoki Shichijo1, Akira Maekawa1, Takashi Kanesaka1, Yoji Takeuchi1, Koji Higashino1, Noriya Uedo1 and Kazuhide Higuchi2
Abstract Background: The current virtual chromoendoscopy equipment cannot completely detect superficial squamous cell carcinoma (SCC) in the esophagus, despite its development in the recent years. Thus, in this study, we aimed to elucidate the appropriate air volume during endoscopic observation to improve the visibility of esophageal SCC. Methods: This retrospective study included a total of 101 flat type esophageal SCCs identified between April 2017 and January 2019 at the Department of Gastrointestinal Oncology, Osaka International Cancer Institute. Video images of narrow band imaging (NBI) under both less-air and standard-air conditions were recorded digitally. Videos were evaluated by five endoscopists. Relative visibility between less-air and standard-air conditions of the brownish area, brownish color change of the epithelium, and dilated intrapapillary capillary loop (IPCL) were graded as 5 (definitely better under less-air condition) to 1 (definitely worse under less-air condition), with 3 indicating average visibility (equivalent to standard-air observation). Results: The mean (standard deviation) visibility score of the brownish area, brownish color change of the epithelium, and dilated IPCLs under less-air condition were 3.94 (0.58), 3.73 (0.57), and 4.13 (0.60), respectively, which were significantly better than that under standard-air condition (p
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