Red Dichromatic Imaging Improves the Recognition of Bleeding Points During Endoscopic Submucosal Dissection

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Imaging Technology

Background:

• Previous research suggests red dichromatic imaging (RDI) improves gastrointestinal bleeding visibility.
• Effective identification of bleeding is crucial for successful endoscopic submucosal dissection (ESD).

Purpose of the Study:

• To compare the recognition of bleeding points during ESD using RDI versus standard white light imaging (WLI).
• To assess the impact of RDI on the accuracy of identifying virtual hemostasis points.

Main Methods:

• Paired videos of active bleeding during esophageal or gastric ESD under WLI and RDI were recorded.
• Six endoscopists identified virtual hemostasis points on still images from these videos.
• The accuracy of identification was scored, and color differences between WLI and RDI were analyzed.

Main Results:

• RDI demonstrated significantly higher visibility scores and recognition rates for bleeding points compared to WLI (62.1% vs. 27.6%).
• Trainees using RDI showed a higher recognition rate than experts using WLI (60.3% vs. 43.1%).
• RDI exhibited a significantly greater median color difference, correlating strongly with improved visibility scores.

Conclusions:

• Red dichromatic imaging (RDI) offers superior recognition of bleeding points during endoscopic submucosal dissection (ESD) compared to white light imaging (WLI).
• Further investigation is recommended to determine if RDI can enhance overall ESD procedure outcomes.