Diagnosis of depressed-type early gastric cancer using small-caliber endoscopy with flexible spectral imaging color enhancement.
OBJECTIVE
Small-caliber endoscopy has lower resolution than normal-caliber endoscopy, limiting its use in routine outpatient practice. Flexible spectral imaging color enhancement (FICE) strengthens the color contrast of depressed-type early gastric cancer without magnification. The aim of the present study was to evaluate the detection of depressed-type early gastric cancer using small-caliber endoscopy with the FICE system.


METHODS
Eighty-two patients diagnosed with depressed-type early gastric cancer by standard endoscopy and biopsy were evaluated by small-caliber endoscopy. FICE images and conventional images were compared. Color differences in all 82 lesions were measured between malignant lesions and the surrounding mucosa using the Commission Internationale de L'Eclairage (CIE) 1976 color space.


RESULTS
Most cancers were readily detected as reddish lesions on FICE images. Lines of demarcation between the malignant lesion and the surrounding mucosa were easily identified with FICE images, as such cancers could be clearly distinguished from the surrounding atrophic mucosa. Greater median color differences between malignant lesions and the surrounding mucosa were present in FICE images compared with conventional images, resulting in images with better contrast (27.2 vs 18.7, P<0.0001).


CONCLUSIONS
Small-caliber endoscopy with the FICE system provides better color contrast of depressed-type early gastric cancers than conventional small-caliber endoscopy, and the FICE system may facilitate the diagnosis of this type of cancer as a new endoscopic modality.
Department of Internal Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan. osawa@jichi.ac.jp
Hiroyuki
H
Osawa
Hironori
H
Yamamoto
Yoshimasa
Y
Miura
Hironari
H
Ajibe
Hakuei
H
Shinhata
Mitsuyo
M
Yoshizawa
Keijiro
K
Sunada
Sachiko
S
Toma
Kiichi
K
Satoh
Kentaro
K
Sugano
D000368:Aged; D003116:Color; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology