Novel physiological analysis using blood flow velocity for colonic polyps: Pilot study.

Area of Science:

• Gastroenterology
• Medical Imaging
• Oncology

Background:

• Real-time visualization of red blood cell flow in subepithelial microvessels is achievable with magnifying endoscopy.
• Microvascular blood flow velocity in the colorectum remains largely uninvestigated.

Purpose of the Study:

• To evaluate microvascular blood flow velocity in colonic polyps.
• To compare blood flow velocity between adenomas (ADs), hyperplastic polyps (HPs), and surrounding mucosa.

Main Methods:

• Magnifying blue laser imaging (BLI) was used to assess blood flow velocity in 50 colonic lesions (30 ADs, 20 HPs) and adjacent mucosa before resection.
• Mean blood flow velocity was calculated using the movement distance of tagged red blood cells in split video images from magnifying BLI.

Main Results:

• Mean microvascular blood flow velocity was significantly lower in ADs (1.65±0.66 mm/sec) compared to HPs (2.83±1.10 mm/sec) and surrounding mucosa (3.73±1.11 mm/sec) (P < 0.001).
• The ratio of blood flow velocity relative to surrounding mucosa was also significantly lower in ADs (0.41±0.16) than in HPs (0.89±0.25) (P < 0.001).

Conclusions:

• Mean microvascular blood flow velocity is significantly reduced in colonic adenomas compared to hyperplastic polyps and normal colonic mucosa.
• This dynamic assessment of microvascular blood flow velocity using magnifying endoscopy may aid in distinguishing between adenomas and hyperplastic polyps.