Gastroenterology

Gastroenterology

Volume 134, Issue 1, January 2008, Pages 327-340
Gastroenterology

AGA Institute
American Gastroenterological Association (AGA) Institute Technology Assessment on Image-Enhanced Endoscopy

https://doi.org/10.1053/j.gastro.2007.10.062Get rights and content

This document presents the official recommendations of the American Gastroenterological Association (AGA) Institute Technology Assessment on “Image-Enhanced Endoscopy.” It was approved by the Clinical Practice and Economics Committee on August 3, 2007, and by the AGA Institute Governing Board September 27, 2007.

Section snippets

Technology Assessment

The following guidelines were developed to assist physicians in the appropriate use of various modalities of contrast enhancement of endoscopic images, termed “image-enhanced endoscopy” (IEE). They emanate from a comprehensive review of the medical literature pertaining to IEE, which previously required the use of dyes and was called chromoendoscopy but more recently can also be accomplished using optical and/or electronic technology. The new IEE technology will allow us to visualize the

Conclusions

IEE has been applied as an adjunctive endoscopic diagnostic and treatment tool in specialized academic centers but is otherwise not currently in widespread use. There are sufficient data to support its use in the detection of early squamous cell carcinoma of the esophagus and in the management of early gastric cancer and superficial colorectal lesions. Potential barriers to the dissemination of IEE include perceptions of its inefficiency and exuberant cost, inadequate mechanism for

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      1) Absorptive stains (ie, methylene blue, acetic acid, crystal violet, and Lugol) have differential absorptive properties based on cell type, and in the case of methylene blue, the dye is absorbed by intestinal epithelial cells, and not the epithelia of squamous or gastric mucosa.10,11 ( 2) Contrast, or nonabsorptive stains (ie, indigo carmine), do not react with the cells; instead the dye accentuates the topography, mucosal surface, and border of a lesion by accumulating in the grooves and crevices of a mucosal lesion.10,12 ( 3) Reactive stains, such as Congo red and phenol red, change color during a chemical reaction when it comes into contact with acidic and alkaline environments on the surface, respectively.

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