Enhanced Submucosal Clarity with ACI: A New Frontier in Therapeutic Endoscopy

Fujifilm had previously introduced two imaging enhancement modalities to support lesion detection and characterisation by high-contrasting LCI and BLI images.

Now Amber-Red Colour Imaging (ACI) is an observation mode that combines LCI colour enhancement technology with brightness enhancement technology.

ACI specifically aims to visualize nuances in red coloration while maintaining a colour tone similar to white light imaging (WLI), potentially making it a tool for identifying bleeding sources during ESD and other 3rd space endoscopy treatments.

I think using (ACI) to identify the muscle versus submucosal plane keeps you in the right plane all along and makes your ESD safer and quicker. This will reduce the learning curve of beginners and make ESD more widely available

Professor Pradeep Bhandari, Professor of Gastroenterology, Portsmouth Hospitals University NHS Trust

During submucosal dissection, the use of ACI mode makes it easier to differentiate the mucosa, submucosa and underlying proper muscle layer compared to white light imaging. Blood vessels in the submucosa could be better identified and prophylactically treated.

Dr Roos Pouw, Consultant Gastroenterologist, Amsterdam University Medical Center

*Maruoka R, Esaki M, Minoda Y et al. Enhanced visualization of vessels in submucosa by amber red color imaging in colonic endoscopic submucosal dissection. Endoscopy 2024; 56(S01): 601 – 602. doi:10.1055/a-2351-3985

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