title: The detection of surface patterns by flexible spectral imaging color enhancement without magnification for diagnosis of colorectal polyps.
abstract: OBJECTIVE
  Flexible spectral imaging color enhancement (FICE), or image-enhanced endoscopy, can enhance visualization of surface and vascular patterns of colorectal polyps. Resolution of FICE has recently been improved. We evaluated diagnostic accuracy for neoplastic and non-neoplastic colorectal polyp differentiation with detection of surface patterns by FICE without magnification.
  
  
  METHODS
  Retrospective analysis of 151 colorectal polyps evaluated by FICE without magnification was performed. Neoplastic surface patterns were defined as tubular and oval pit. We aimed to determine sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy in correlating diagnosis by FICE without magnification with histology. Moreover, findings were compared to those of white-light endoscopy (WL) and chromoendoscopy (CHR).
  
  
  RESULTS
  Of the 151 colorectal polyps, 95 were identified as neoplastic and 56 were identified as non-neoplastic. FICE without magnification had a sensitivity of 89.4%, specificity of 89.2%, PPV of 93.4%, NPV of 83.3%, and accuracy of 89.4%. The accuracy of FICE value was higher than that of WL (sensitivity of 74.7%, specificity of 73.2%, PPV of 82.5%, NPV of 63.0%, and accuracy of 74.1%) and was worse than that of CHR (sensitivity of 96.8%, specificity of 89.2%, PPV of 93.9%, NPV of 96.1%, and accuracy of 94.7%). Imaging evaluation was validated by inter-/intra-observer measurements, demonstrating consistent results.
  
  
  CONCLUSIONS
  The detection of surface patterns by FICE without magnification is useful for differential diagnosis of colorectal polyps. We believe that FICE without magnification is more convenient and easier method than CHR.
authors.affiliation: Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. naohisa@koto.kpu-m.ac.jp
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yoshida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Naito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inada
authors.forename: Munehiro
authors.initials: M
authors.lastname: Kugai
authors.forename: Ken
authors.initials: K
authors.lastname: Inoue
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Osamu
authors.initials: O
authors.lastname: Handa
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Takagi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Konishi
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Yagi
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Wakabayashi
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D003111:Colonic Polyps / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity