Linked color imaging application for improving the endoscopic diagnosis accuracy: a pilot study

Sun, Xiaotian; Dong, Tenghui; Bi, Yiliang; Min, Min; Shen, Wei; Xu, Yang; Liu, Yan

doi:10.1038/srep33473

Cited by 52 publications

(48 citation statements)

References 23 publications

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“…To make it easier to discriminate the color tone of the mucosal surface, the system expands and reduces color simultaneously for acquired images to make a reddish color appear redder and a whitish color appear whiter. The usefulness of LCI has been highlighted in recent years in terms of obvious improved visibility for gastric cancer [6, 7], chronic gastritis [9], colon cancer [10], and gastroduodenal and colorectal lesions [11]. Fukuda et al [6] and Ono et al [7] reported the early detection of flat gastric cancers observed as reddish lesions distinct from surrounding mucosa using LCI.…”

Section: Discussionmentioning

confidence: 99%

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Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

et al. 2018

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Background/Aims: To evaluate the usefulness of linked color imaging (LCI) and blue LASER imaging (BLI) in Barrett’s esophagus (BE) compared with white light imaging (WLI). Methods: Five expert and trainee endoscopists compared WLI, LCI, and BLI images obtained from 63 patients with short-segment BE. Physicians assessed visibility as follows: 5 (improved), 4 (somewhat improved), 3 (equivalent), 2 (somewhat decreased), and one (decreased). Scores were evaluated to assess visibility. The inter- and intra-rater reliability (intra-class correlation coefficient) of image assessments were also evaluated. Images were objectively evaluated based on L* a* b* color values and color differences (ΔE*) in a CIELAB color space system. Results: Improved visibility compared with WLI was achieved for LCI: 44.4%, BLI: 0% for all endoscopists; LCI: 55.6%, BLI: 1.6% for trainees; and LCI: 47.6%, BLI: 0% for experts. The visibility score of trainees compared with experts was significantly higher for LCI (p = 0.02). Intra- and inter-rater reliability ratings for LCI compared with WLI were “moderate” for trainees, and “moderate-substantial” for experts. The ΔE* revealed statistically significant differences between WLI and LCI. Conclusion: LCI improved the visibility of short-segment BE compared with WLI, especially for trainees, when evaluated both subjectively and objectively.

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Section: Discussionmentioning

confidence: 99%

“…In recent years, the use of LCI has been reported in studies of gastric cancer [6-8], chronic gastritis [9], colon cancer [10], gastric and colon lesions [11], and ulcerative colitis [12]. However, reports of the diagnosis of Barrett’s esophagus using LCI and BLI are nonexistent.…”

Section: Introductionmentioning

confidence: 99%

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

et al. 2018

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“…RGB analysis is defined by the International Electrotechnical Commission as being able to describe the three color channels and their mutual superposition, which has been widely used in image processing and digital media. Sun et al firstly applied the ratio of RGB in LCI images to diagnose gastric mucosal lesions, and they discovered that R/(G+B) was the maximum AUC with a sensitivity of 0.514 and a specificity of 0.773 [8]. However, most cases were chronic gastritis and only 2 cases were gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that colors can be quantified, the RGB pixel brightness model may be relatively objective for EGC screening. Based on another pilot study, RGB pixel brightness is different between LCI and whitelight imaging (WLI) in gastritis patients [8]. To the best of our knowledge, whether or not the KCG score and Hp infection would affect the judgment of RGB pixel brightness for early gastric cancer was unknown.…”

Section: Background and Aimsmentioning

confidence: 98%

RGB Pixel Brightness Characteristics of Linked Color Imaging in Early Gastric Cancer: A Pilot Study

Sun

Zhao

2020

Gastroenterology Research and Practice

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Background and Aims. Linked color imaging (LCI) helps screen and diagnose for early gastric cancer by color contrast in different mucosa. RGB (red, green, and blue) pixel brightness quantifies colors, which is relatively objective. Limited studies have combined LCI images with RGB to help screen for early gastric cancer (EGC). We aimed to evaluate the RGB pixel brightness characteristics of EGC and noncancer areas in LCI images. Methods. We retrospectively reviewed early gastric cancer (EGC) patients and LCI images. All pictures were evaluated by at least two endoscopic physicians. RGB pixel brightness analysis of LCI images was performed in MATLAB software to compare the cancer with noncancer areas. Receiver operating characteristic (ROC) curve was analyzed for sensitivity, specificity, cut-off, and area under the curve (AUC). Results. Overall, 38 early gastric cancer patients were enrolled with 38 LCI images. Pixel brightness of red, green, and blue in cancer was remarkably higher than those in noncancer areas (190.24±37.10 vs. 160.00±40.35, p<0.001; 117.96±33.91 vs. 105.33±30.01, p=0.039; 114.36±34.88 vs. 90.93±30.14, p<0.001, respectively). Helicobacter plyori (Hp) infection was not relevant to RGB distribution of EGC. Whether the score of Kyoto Classification of Gastritis (KCG) is ≥4 or <4, the pixel brightness of red, green, and blue was not disturbed in both cancer and noncancer (p>0.05). Receiver operating characteristic (ROC) curve for differentiating cancer from noncancer was calculated. The maximum area under the curve (AUC) was 0.767 in B/G, with a sensitivity of 0.605, a specificity of 0.921, and a cut-off of 0.97. Conclusions. RGB pixel brightness was useful and more objective in distinguishing early gastric cancer for LCI images.

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“…As for another method, two experiments were designed according to the diagnoses of endoscopists combined with histological verification. Two sets of results based on pathology including random crossed experiments [12] for detection and diagnostic accuracy experiments for classification [13] are showed in Table I. In both experiments, the miss and misclassification rates under LCI colonoscopy are an order of magnitude lower than that of WL, respectively, which demonstrated the clinical benefits of LCI colonoscopy in clinical adjuvant diagnosis, compared with WL endoscopy.…”

Section: Introductionmentioning

confidence: 97%

Quantitative Comparisons of Linked Color Imaging and White-Light Colonoscopy for Colorectal Polyp Analysis

Wei

Xie

et al. 2018

2018 International Conference on Network Infrastructure and Digital Content (IC-NIDC)

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The performance of imaging techniques has an important influence on the clinical diagnostic strategy of colorectal cancer. Linked color imaging (LCI) by laser endoscopy is a recently developed techniques, and its advantage in improving the analysis accuracy of colorectal polyps over white-light (WL) endoscopy has been demonstrated in previous clinical studies. However, there are no objective criteria to evaluate and compare the aforementioned endoscopy methods. This paper presents a new criterion, namely entropy of color gradients image (ECGI), which is based on color gradients distribution and provides a comprehensive and objective evaluating indicator of the performance of colorectal images. Our method extracts the color gradient image pairs of 143 colonoscopy polyps in the LCI-PairedColon database, which are generated with WL and LCI conditions, respectively. Then, we apply the morphological method to fix the deviation of light-reflecting regions, and the ECGI scores of sample pairs are calculated. Experimental results show that the average ECGI scores of LCI images (5.7071) were significantly higher than that of WL (4.6093). This observation is consistent with the clinical studies. Therefore, the effectiveness of the proposed criterion is demonstrated.

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Linked color imaging application for improving the endoscopic diagnosis accuracy: a pilot study

Cited by 52 publications

References 23 publications

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

RGB Pixel Brightness Characteristics of Linked Color Imaging in Early Gastric Cancer: A Pilot Study

Quantitative Comparisons of Linked Color Imaging and White-Light Colonoscopy for Colorectal Polyp Analysis

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