大腸内視鏡における画像強調観察のエビデンスと展望

Image-enhanced endoscopy in the colorectum: Current data and future perspectives

要旨

大腸内視鏡において，病変の見逃しはpost-colonoscopy colorectal cancer（PCCRC）の主要因であり，腺腫検出率（adenoma detection rate：ADR）の向上は重要な課題である。画像強調内視鏡（image-enhanced endoscopy：IEE）は病変の視認性を高め，検出能を改善することが期待されてきた。Narrow band imaging（NBI），blue laser imaging（BLI），linked color imaging（LCI），texture and color enhancement imaging（TXI）などのさまざまな画像強調内視鏡が開発され，それぞれの特性を理解することは質の高い大腸内視鏡を提供することに寄与すると考える。本稿では，それぞれの画像強調内視鏡の特徴とこれまでに報告したエビデンスを概説し，画像強調内視鏡の今後を展望したい。

　Missed lesions during colonoscopy are a main factor in post-colonoscopy colorectal cancer (PCCRC). Therefore, reducing the adenoma miss rate and improving the adenoma detection rate (ADR) remain critical issues in colorectal cancer prevention. Image-enhanced endoscopy (IEE) has been developed to enhance the visibility of colorectal lesions and thereby improve detectability. Various modalities have been introduced, including narrow band imaging (NBI), blue laser imaging (BLI), linked color imaging (LCI), and texture and color enhancement imaging (TXI). Understanding the characteristics of these techniques is essential for providing high-quality colonoscopy. In this review, we summarize the current evidence regarding each IEE modality and discuss future perspectives in colorectal endoscopy.