Рекомендации

“I usually use as default i-scan 1 (SE) as a detection mode and I usually turn on i-scan 3 (OE) when I want to better visualize the mucosal and vascular pattern. I find it particularly useful in Barrett’s oesophagus to diagnose high grade dysplasia area, for rectal and colonic polyp to decide between ESD or piece meal EMR when i-scan 3 (OE) shows aspect of carcinoma in situ or limited to sm1“

"I usually use the i-scan 1 (SE) at the beginning of all my endoscopic studies. It brings the characteristics of the white light endoscopy with more resolution of the surface which is better to identify lesions. Once I identify a lesion I turn to i-scan 2 (TE) to characterize the vascularity. The new EPK-i7010 with the i-scan OE gives the best features of

mucosal pattern and vascularity with the same tool. In Barrett’s oesophagus the new EPK-i7010 gives the chance to discriminate in the best way the suspicious areas for dysplasia. This allows to take less biopsies in the protocol with better results of getting the dysplastic Barrett’s and identifying the intramucosal neoplasia.“

“Several studies have shown that digital-based chromoendoscopy is accurate in predicting the histology of polyps of the colon and rectum. The i-scan 1 (SE) is my favorite mode in order to obtain the sharpest image.

In 2013, we observed good interobserver agreement among endoscopists in the evaluation of neoplastic and non-neoplastic lesions visualized with the PENTAX Medical i-scan technique but a poor agreement in the

evaluation of pit-pattern and margins. The recent addition of i-scan 3 (OE) is useful as it really helps me to better assess the vascular and pit patterns of the lesion and accurately identify its margins.”

“i-scan 3 (OE) combines the versatility and flexibility of i-scan with ever sharper and crisper pictures. While i-scan 1 (SE) is my standard setting during every procedure because it gives you the extra bit of contrast and

detail to detect even very subtle changes of the mucosa, i-scan 3 (OE) offers an extremely sharp view of the surface pattern for example in Barrett’s oesophagus. Combine it with the capabilities of the optical

zoom endoscopes and you get the ultimate diagnostic tool in both lower and upper GI tract.”

"I think that i-scan OE represents a further step forward in the diagnostic capabilities of endoscopy. With the i-scan system we can see the mucosa and the lesions with different visualizations that allows to collect different information, specific for each enhance. We can choose the most suitable i-scan function depending on:

anatomical site, pathology or just according to the way the endoscopist feels more confident to be able to make the diagnosis. After my first experience with i-scan OE, I feel that it allows to better study the pit pattern of healthy mucosa and of lesions.

The other 2 important aspects that I want to underline are:

– i-scan 3 (OE) should allow to use the existing classifications already accepted in the literature based on Optical Enhancement making the data resulting from the use of PENTAX Medical endoscopes more comparable.

– i-scan 1 (SE) and i-scan 2 (TE), in addition to the diagnostic capability demonstrated in the literature, allows also to perform an enhanced observation also in difficult conditions like bleeding, bile or fecal residue, when it’s not possible to use an optical system.”

”The PENTAX Medical High-Definition White Light (HD WL) image is a major advance but when I switch i-scan 1 (SE) on then the image becomes sharper and crisper without losing any other attribute so I don’t see any reason why i-scan 1 (SE) should not be left on at all times. Once I find a subtle abnormality or any obvious lesion then I switch on i-scan 2 (TE) and that really highlights the lesion from the surrounding normal mucosa. Once the presence of neoplasia is confirmed then I switch on i-scan 3 (OE) to fine evaluate the surface and vessel patterns of the lesion (to differentiate neoplastic from non-neoplastic lesion) and identify the exact margins of the lesion. The recent addition of i-scan OE to the PENTAX Medical family has been a major step forward in evaluation and characterization of gastrointestinal neoplasia.”

“I use systematically advanced imaging techniques such as i-scan and i-scan OE in the work-up of patients with suspicion of Barrett’s associated neoplasia to help in the detection of small subtle lesions.“

"In my own practice I rely on i-scan 1 (SE) as my default initial mode for interrogating the upper GI tract. This has superseded the white light mode for me and helps me to assess and detect early cancers. The depth and image resolution is excellent at defining mucosal patterns that when disordered or irregular lead one to suspect neoplasia. My own preference is then to switch to i-scan 2 (TE) to better characterize the lesion in terms of borders but also it allows one to interpret vascularity in great detail. Coupled with the magnification range of endoscopes I have used this mode with much success, for example in patients with early squamous cell cancer of the esophagus. With the combination of conventional chromoendoscopy and agents such as acetic acid it can provide very accurate delineation of flat lesions. Over the past six months I have been using the new optical enhancements that PENTAX Medical have developed beyond the conventional i-scan modes described above. The filtering technology here provides a very distinct and lighter image of the vascularity and mucosal pit patterns that become disordered in early cancer and coupled with i-scan 1 (SE) have in my practice become the two most commonly used enhanced imaging modalities that I use.”

“In IBD, one can expect also to use the i-scan 3 (OE), especially to predict microscopic inflammation. This concept and assessment is very important for our patients, because mucosal healing is associated with less steroid use, less hospitalization and less surgery for patients. I suspect that the i-scan 3 (OE) technology will be very helpful for the assessment of mucosal healing in patients with inflammatory bowel diseases. In this way, it will help to guide whether medical therapy should be advanced for patients with active mucosal disease or whether medical therapy can be decreased for those who demonstrate good mucosal healing.”

"In order to implement Optical Enhancement (OE) in routine clinical practice, the endoscopist must firstly understand the rationale of this new technology. What is the additional value? HD imaging remains key. Besides this, contrast enhancement using i-scan OE, which is an image pre-processing technology, highlights the epithelial mucosal surface pattern and especially the vascular pattern into detail. i-scan OE facilitates detection and in-vivo diagnosis of lower gastrointestinal tract pathology enabling targeted endotherapy.“