title: Diagnosis of endoscopic Barrett's esophagus by transnasal flexible spectral imaging color enhancement.
abstract: BACKGROUND
  The diagnosis of endoscopic Barrett's esophagus (BE) has been under discussion for the past decade because palisade vessels may be obscured by inflammation or the location of upper end of gastric fold may be diversely changed. The flexible spectral imaging color enhancement (FICE) system can reconstruct improved spectral images decomposed from ordinary endoscopic images with free selection of three wavelengths, and can provide non-magnified images with high light intensity.
  
  
  METHODS
  To evaluate whether the transnasal FICE system enables easier diagnosis of endoscopic BE, 72 patients with endoscopic BE were observed prospectively with a transnasal endoscope using both conventional images and FICE images. The visualization of palisade vessels and the identification of the demarcation between endoscopic BE mucosa and gastric mucosa were compared between FICE images and conventional endoscopic images, and the CIELAB color differences were calculated among palisade vessels, background BE mucosa and gastric folds.
  
  
  RESULTS
  Palisade vessels could be more clearly visualized in BE mucosa with transnasal FICE than with conventional endoscopy. Demarcation between whitish BE mucosa and the upper end of the brownish gastric mucosa could be clearly identified using transnasal FICE images. Greater color differences existed with FICE images between palisade vessels and background BE mucosa as well as between BE mucosa and gastric folds than with conventional images, leading to better contrasting images.
  
  
  CONCLUSIONS
  The transnasal FICE system enables clear visualization of palisade vessels and provides better contrasting images of the demarcation between the BE mucosa and the gastric mucosa, and thus contributes to easier diagnosis of endoscopic BE.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan. osawa@jichi.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Osawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Naoshi
authors.initials: N
authors.lastname: Yamada
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Yoshizawa
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kita
authors.forename: Hironari
authors.initials: H
authors.lastname: Ajibe
authors.forename: Kiichi
authors.initials: K
authors.lastname: Satoh
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
mesh_terms: D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System / Q000379:methods*; D004867:Equipment Design; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies