Diagnosis of small flat early gastric cancer by flexible spectral imaging color enhancement

Toma, Sachiko; Osawa, Hiroyuki; Yoshizawa, Mitsuyo; Yamamoto, Hironori; Nakano, Hidetoshi; Ajibe, Hironari; Satoh, Kiichi; Sugano, Kentaro

doi:10.1007/s12328-010-0142-4

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Although there are no collected data regarding missed early gastric cancers, a case report was published about a flat cancer missed several times by per‐oral endoscopy with WLI alone and detected using a small‐caliber scope with FICE . Figure shows a cancer in the cardia missed by WLI with per‐oral endoscopy.…”

Section: Using Fice For Screening and Detailed Examinationsmentioning

confidence: 99%

Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology

Osawa

Yamamoto

2013

Digestive Endoscopy

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The usefulness of flexible spectral imaging color enhancement (FICE) has been reported for evaluating the esophagus, stomach, and small and large intestine. Higher contrast is shown between cancer and the surrounding mucosa in the esophagus and stomach and may facilitate the detection of gastric cancers missed by white light imaging alone. The surface patterns of gastric mucosa are clearly visualized in non-malignant areas but are irregular and blurred in malignant areas, leading to clear demarcation. Capsule endoscopy with FICE detects angiodysplasia and erosions of the small intestine. The surface and vascular pattern with FICE is useful for the differential diagnosis of colorectal polyps. However, FICE remains somewhat poor at visualizing mucosal microvasculature on a tumor surface. Narrow-band imaging (NBI) is dark in observing whole gastric mucosa and poor at visualizing mucosal microstructure. Blue laser imaging (BLI) has the potential to resolve these limitations. Narrow-band laser light combined with white light shows irregular microvessels on both differentiated and undifferentiated gastric cancer similar to those using NBI. In addition, irregular surface patterns including minute white zones are clearly seen on the uneven surface of differentiated lesions, resulting in exclusion of undifferentiated lesions. Using both distant and close-up views, a high contrast between green intestinal metaplasia and brown gastric cancer may lead to early detection of gastric cancers and determination of a demarcation line. BLI produces high-contrast images in esophageal cancer with clear vision of intrapapillary capillary loops and also predicts the histopathological diagnosis and depth of invasion in colorectal neoplasms.

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Section: Using Fice For Screening and Detailed Examinationsmentioning

confidence: 99%

Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology

Osawa

Yamamoto

2013

Digestive Endoscopy

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143

119

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“…Ultrathin endoscopy has been shown to result in poor visibility of malignant lesions in the proximal stomach using a xenon endoscope 9 , but not using laser endoscopy, although it has good visibility around the lesser curvature of the angle 28 29 . In this study, ultrathin LCI showed high visibility scores and significantly higher color differences in the proximal stomach compared with standard WLI.…”

Section: Discussionmentioning

confidence: 99%

Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis

et al. 2022

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Background and study aims Ultrathin endoscopy causes a minimal gag reflex and has minimal effects on cardiopulmonary function. Linked color imaging (LCI) is useful for detection of malignancies in the digestive tract. The aim of this study was to clarify whether LCI with ultrathin endoscopy facilitates detection of early gastric cancer (EGC) despite its lower resolution compared with high-resolution white light imaging (WLI) with standard endoscopy. Patients and methods This was a retrospective analysis with prospectively collected video, including consecutive 166 cases of EGC or gastric atrophy alone. Ninety seconds of screening video was collected using standard and ultrathin endoscopes with both WLI and LCI for each case. Three expert endoscopists assessed each video and the sensitivity of detecting EGC calculated. Color difference calculations were performed. Results Sensitivities using ultrathin WLI, ultrathin LCI, standard WLI, and standard LCI for the identification of cancer were 66.0 %, 80.3 %, 69.9 %, and 84.0 %, respectively. The color difference between malignant lesions and surrounding mucosa with ultrathin LCI and standard LCI were significantly higher than using ultrathin WLI or standard WLI, supported subjectively by the visibility score. Ultrathin LCI color difference and visibility score were significantly higher than standard WLI. Conclusions LCI with a low-resolution ultrathin endoscope is superior to WLI with a high-resolution standard endoscope for gastric cancer screening. This suggests that the high color contrast between EGC and the surrounding mucosa is more important than high-resolution images.

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“…LCI and BLI have been available with one small-caliber endoscope (e.g., EG-L580NW; Fujifilm Co.) using a laser endoscopic system since 2014 and with one (e.g., EG-740N; Fujifilm Co.) using an LED endoscopy system since 2018. These endoscopes are characterized by a small radius at the tip, which allows observation of upper gastrointestinal lesions with a frontal view [38,39]. A recent report showed that WLI using small-caliber endoscopy did not allow the diagnosis of a small red lesion as cancer, but BLI showed a discolored area around the red lesion with irregular vessels, resulting in the accurate diagnosis of an early case of gastric cancer [39].…”

Section: Stomachmentioning

confidence: 99%

Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening

et al. 2018

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White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication.LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.

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Diagnosis of small flat early gastric cancer by flexible spectral imaging color enhancement

Cited by 4 publications

References 14 publications

Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology

Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology

Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis

Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening

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