title: Flexible spectral imaging color enhancement (FICE) is useful to discriminate among non-neoplastic lesion, adenoma, and cancer of stomach.
abstract: BACKGROUND
  Studies regarding the discrimination of non-neoplastic lesion, adenoma, and cancer of the stomach using magnifying endoscopy with flexible spectral imaging color enhancement system (FIME) in each different channel of that system have not yet been reported.
  
  
  OBJECTIVE
  To ascertain  the usefulness of FIME discriminating among the three kinds of gastric lesions.
  
  
  METHODS
  When finding a lesion to be a  possible neoplasm using conventional endoscopy, the examiner discriminated among the three kinds of gastric lesions by observing the pit pattern on the lesion using magnifying endoscopy with white light (WLME) and then recorded the image. The procedure was repeated three more times with FIME with channel 0, 2, and 4. The four recorded images per lesion were then given to four raters for discriminating among the three kinds of gastric lesions.
  
  
  RESULTS
  The proportion of agreement and the degree of agreement between endoscopic and pathological diagnosis (AEP) by WLME were 0.85 and 0.76, respectively, and those by FIME were 0.91 and 0.86, respectively. All AEPs from discriminations with FIME was higher than that with WLME. AEPs from the discriminations with FIME with channel 4 were higher than those with FIME with channel 0 or 2. The degree of interobserver agreement among the results of the four raters was 0.42 for WLME and 0.50-0.59 for FIME with each of the three different channels.
  
  
  CONCLUSIONS
  FICE is useful in discriminating among non-neoplastic lesions, adenoma, and cancer of the stomach, and channel 4 of the FICE is better than channel 0 and 2 for the discriminations.
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, South Korea. restwant@hanmail.net
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Kyu Seong
authors.initials: KS
authors.lastname: Lim
authors.forename: Jun Uk
authors.initials: JU
authors.lastname: Lim
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Jeon
authors.forename: Hyun Phil
authors.initials: HP
authors.lastname: Shin
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Eun Kyeong
authors.initials: EK
authors.lastname: Lee
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Park
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Cha
authors.forename: Kwang Ro
authors.initials: KR
authors.lastname: Joo
authors.forename: Joung Il
authors.initials: JI
authors.lastname: Lee
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D003116:Color; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013272:Stomach Diseases / Q000175:diagnosis* / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology