title: Effectiveness of color intensity analysis using updated autofluorescence imaging systems for serrated lesions.
abstract: OBJECTIVE
  We previously reported the effectiveness of color intensity analysis using autofluorescence imaging (AFI) for differentiating colorectal neoplastic lesions from non-neoplastic lesions. However, the ability of AFI systems for differentiating serrated lesions has not been evaluated. In the present study, we assessed the effectiveness of color intensity analysis using updated AFI systems for evaluating serrated lesions.
  
  
  METHODS
  We retrospectively reviewed the data for 48 consecutive patients with 87 serrated lesions that were examined using updated AFI systems and resected at Jikei University Hospital. The mean green/red (G/R) ratio, which is obtained by dividing the mean green color intensities by the mean red color intensities, was calculated for each serrated lesion and compared between hyperplastic polyps, sessile serrated adenomas/polyps (SSA/P) with cytological dysplasia, and SSA/P without cytological dysplasia. We also assessed the area under the receiver operating characteristic curve (AUC) for determining SSA/P (both with and without cytological dysplasia) and SSA/P with cytological dysplasia.
  
  
  RESULTS
  The AUC for determining SSA/P was 0.68; however, the AUC for determining SSA/P with cytological dysplasia was 0.97. With a cut-off for the G/R ratio of <0.93, the sensitivity, specificity, positive predictive value, and negative predictive value for SSA/P with cytological dysplasia were 95.5%, 91.0%, 77.8%, and 98.3%, respectively.
  
  
  CONCLUSIONS
  Color intensity analysis of serrated lesions using updated AFI systems could effectively distinguish SSA/P with cytological dysplasia from hyperplastic polyps and SSA/P without cytological dysplasia.
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Tamai
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Inomata
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ide
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Dobashi
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sumiyama
mesh_terms: D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: adenoma; autofluorescence imaging; colon; color; polyp