Recognition of endoscopic diagnosis in differentiated-type early gastric cancer by flexible spectral imaging color enhancement with indigo carmine.
OBJECTIVE
To evaluate the usefulness of flexible spectral imaging color enhancement with indigo carmine (I-FICE) in early gastric cancer (EGC) demarcation.


METHODS
The study participants were 29 patients with differentiated-type EGC. The endoscope was fixed and images of the same area of EGC demarcations in each lesion were obtained using four different methods (WLE, flexible spectral imaging color enhancement (FICE), CE, and I-FICE). FICE mode at R 550 nm (Gain: 2), G 500 nm (Gain: 4), and B 470 nm (Gain: 4) was used. Four endoscopists ranked the images obtained by each method on the basis of the ease of recognition of demarcation using a 4-point system. We calculated the standard deviation of pixel values based on L*, a*, and b* color spaces in the demarcation region (Lab-SD score).


RESULTS
The median ranking score for I-FICE images was significantly higher than that obtained from the other methods. Further, the average Lab-SD score was significantly higher for I-FICE images than for images obtained by the other methods. There was a good correlation between the ranking score and Lab-SD score.


CONCLUSIONS
EGC demarcations were most easily recognized both subjectively and objectively using I-FICE image, followed by CE, FICE and WLE images.
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. osamu-d@koto.kpu-m.ac.jp
O
O
Dohi
N
N
Yagi
T
T
Wada
N
N
Yamada
N
N
Bito
S
S
Yamada
Y
Y
Gen
N
N
Yoshida
K
K
Uchiyama
T
T
Ishikawa
T
T
Takagi
O
O
Handa
H
H
Konishi
N
N
Wakabayashi
S
S
Kokura
Y
Y
Naito
T
T
Yoshikawa
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D004396:Coloring Agents; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007203:Indigo Carmine; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology
D004396:Coloring Agents; D007203:Indigo Carmine