Diagnosis of elevated-type early gastric cancers by the optimal band imaging system.
BACKGROUND
The endoscopic diagnosis of an elevated-type early gastric cancer is often difficult. The optimal band imaging (OBI) system can reconstruct the best spectral images decomposed from ordinary endoscopic images with free selection of 3 wavelengths and provide unmagnified images with high light intensity as well as magnified images.


OBJECTIVE
To evaluate whether the OBI system facilitates detection of the demarcation lines between an elevated-type early gastric cancer and surrounding tissue and thus is more helpful for performing endoscopic therapy.


METHODS
A prospective study.


METHODS
Jichi Medical University, Japan.


METHODS
Seventy-five patients, 81 lesions with an elevated-type early gastric cancer.


METHODS
A comparison between OBI images and conventional endoscopic images in the identification of the demarcation lines of an elevated-type early gastric cancer without magnification and the rate of success in identifying the abnormal surface structure of cancer by using low-magnified OBI images.


RESULTS
Demarcation lines were easily identified in OBI images, even without magnification, because such cancers could be clearly distinguished from the surrounding whitish atrophic mucosa. Inexperienced endoscopists could determine demarcation lines with significantly greater accuracy with unmagnified OBI images than with conventional images. With 40-fold magnification, irregular microstructural or nonstructural patterns were also found within cancer lesions in all cases studied but in none of the cases in the surrounding noncancerous mucosa.


CONCLUSIONS
The new contrast images obtained with the OBI system enable better determination of the demarcation lines of elevated-type early gastric cancers, and this system may be useful for performing endoscopic therapy of this type of cancer as a new endoscopic modality.
Yoshizawa
Mitsuyo
M
Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Osawa
Hiroyuki
H
Yamamoto
Hironori
H
Kita
Hiroto
H
Nakano
Hidetoshi
H
Satoh
Kiichi
K
Shigemori
Masato
M
Tsukui
Mamiko
M
Sugano
Kentaro
K
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D016001:Confidence Intervals; D042241:Early Diagnosis; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D020699:Gastroscopes; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology*