title: Differences of image enhancement in image-enhanced endoscopy: narrow band imaging versus flexible spectral imaging color enhancement.
abstract: BACKGROUND
  Narrow band imaging (NBI) can emphasize images of the surface microvasculature of lesions, because the central wavelengths of the NBI filter are 415 and 540 nm and these wavelengths are well absorbed by hemoglobin. Flexible spectral imaging color enhancement (FICE) increases the contrast in depictions of mucosal lesions. However, quantitative evaluation of the image enhancement shown by NBI and FICE has not been reported. The aim of this study was to measure and compare the degrees of image enhancement in NBI and FICE.
  
  
  METHODS
  We compared the visibility of human blood diluted with distilled water between that shown by white-light imaging (WLI) and that shown by NBI or FICE. One milliliter of human blood was plated onto a 12-well transparent plastic plate to set up doubling dilutions, from 1/2 to 1/2(23). High-definition endoscopes were used for each imaging method. A total of 11 endoscopists independently evaluated the visibility of the diluted blood. The median dilution was defined as the limit of visibility in each image.
  
  
  RESULTS
  NBI enabled clearer visualization of the presence of blood compared with conventional WLI. NBI recognized blood contamination up to a 1/2(14) dilution, whereas conventional WLI recognized blood contamination up to a 1/2(11) dilution. In contrast, FICE did not improve the visualization of diluted blood and recognized blood contamination up to a 1/2(10) dilution.
  
  
  CONCLUSIONS
  NBI more effectively enhanced images of diluted blood compared to conventional WLI, while FICE did not improve the visualization of the diluted blood. These data suggest the usefulness of NBI for the early detection of gastrointestinal neoplasia, which is accompanied by abundant neovascularization.
authors: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Syogoin, Sakyo-ku, Kyoto, Japan. mmuto@kuhp.kyoto-u.ac.jp
authors: Manabu
authors: M
authors: Muto
authors: Hirokazu
authors: H
authors: Higuchi
authors: Yasumasa
authors: Y
authors: Ezoe
authors: Takahiro
authors: T
authors: Horimatsu
authors: Shuko
authors: S
authors: Morita
authors: Shin-Ichi
authors: S
authors: Miyamoto
authors: Tsutomu
authors: T
authors: Chiba
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