Evaluation of autofluorescence colonoscopy for diagnosis of superficial colorectal neoplastic lesions

Autofluorescence (AF) imaging, which can potentially differentiate tissue types based on differences in fluorescence emission, may be useful in the diagnosis and treatment of colorectal malignancies. This study was designed to assess the potential usefulness of AF colonoscopy for evaluating superficial colorectal neoplastic lesions. A total of 49 colorectal lesions in 43 patients were investigated. All superficial colorectal neoplastic lesions were identified with white light (WL) colonoscopy. Each detected lesion was investigated by WL colonoscopy, AF colonoscopy, and chromoendoscopy using 0.2% indigo carmine dye. Three endoscopists, blinded to each patient's history, evaluated the still images (as obtained with these three methods) in random order and evaluated their influence on the assessment of lesion visualization. All the lesions were biopsied or resected endoscopically, with the pathological results used as the gold standard. For visualization of the surface appearance and differences in color of the lesions compared with the surrounding mucosa, AF colonoscopy was superior to WL colonoscopy (p < 0.01) and comparable to chromoendoscopy (Mann-Whitney U test). For visualization of the circumferential margin, AF colonoscopy was superior to WL colonoscopy (p < 0.05) but inferior to chromoendoscopy (p < 0.01). AF colonoscopy may be a valuable tool for detection and diagnosis of superficial colorectal neoplastic lesions.