Diagnosis of extent of early gastric cancer using flexible spectral imaging color enhancement

Abstract

The demarcation line between the cancerous lesion and the surrounding area could be easily recognized with flexible spectral imaging color enhancement (FICE) system compared with conventional white light images. The characteristic finding of depressed-type early gastric cancer (EGC) in most cases was revealed as reddish lesions distinct from the surrounding yellowish noncancerous area without magnification. Conventional endoscopic images provide little information regarding depressed lesions located in the tangential line, but FICE produces higher color contrast of such cancers. Histological findings in depressed area with reddish color changes show a high density of glandular structure and an apparently irregular microvessel in intervening parts between crypts, resulting in the higher color contrast of FICE image between cancer and surrounding area. Some depressed cancers are shown as whitish lesion by conventional endoscopy. FICE also can produce higher color contrast between whitish cancerous lesions and surrounding atrophic mucosa. For nearly flat cancer, FICE can produce an irregular structural pattern of cancer distinct from that of the surrounding mucosa, leading to a clear demarcation. Most elevatedtype EGCs are detected easily as yellowish lesions with clearly contrasting demarcation. In some cases, a partially reddish change is accompanied on the tumor surface similar to depressed type cancer. In addition, the FICE system is quite useful for the detection of minute gastric cancer, even without magnification. These new contrasting images with the FICE system may have the potential to increase the rate of detection of gastric cancers and screen for them more effectively as well as to determine the extent of EGC.

Diagnostic ability of magnifying endoscopy with blue laser imaging for early gastric cancer: a prospective study

“…However, it is often difficult to detect gastric superficial adenocarcinomas using conventional endoscopy with white-light imaging (C-WLI). Many clinical studies have reported on the diagnostic performance of EGC by imageenhanced endoscopy (IEE) techniques such as narrow-band imaging (NBI) [2][3][4][5][6][7][8][9] or flexible spectral imaging color enhancement (FICE) [10][11][12]. In particular, magnifying endoscopy with NBI (M-NBI) is a powerful optical IEE that has demonstrated accurate real-time diagnostic performance in EGC compared with C-WLI [5,7].…”

Magnifying Blue Laser Imaging versus Magnifying Narrow-Band Imaging for the Diagnosis of Early Gastric Cancer: A Prospective, Multicenter, Comparative Study

“…However, it is often difficult to diagnose superficial EGC using C-WLI. Image-enhanced endoscopy techniques such as narrow-band imaging (NBI) [1], autofluorescence imaging [2], flexible spectral imaging color enhancement [3,4,5], and i-scan [6] have found wide applications for endoscopic diagnosis of EGC. In particular, magnifying NBI (M-NBI) is reportedly superior to C-WLI for the accurate diagnosis of EGC [7,8,9,10,11,12,13,14].…”

The Usefulness of an Intra-Oropharyngeal U-turn Method using Trans-Nasal Endoscopy for Detecting Superficial Squamous Cell Carcinoma of the Base of the Tongue

“…However recent advances with this procedure have been made, and a new endoscope (model EG-580NW, Fuji Film, Co.) were manufactured beginning in October 2011. This endoscope is a trans-nasal model that provides high-quality endoscopic images with a wide field view of (140°) and is equipped with the flexible spectreal imaging color enhancement (FICE) system, which is based on a spectral estimation technique by which the narrow bandwidth is obtained from white light images without optical filters [13][14]. Unfortunately, the FICE system cannot image distinctive microvessels on the tumor surface as sharply as NBI.…”

“…The outer diameter of the endoscope is 5.9 mm. This endoscope is a trans-nasal model that provides high-quality endoscopic images with a wide field view (of 140°), and is equipped with the flexible spectral imaging color enhancement (FICE) system, which enhances images by extracting spectral images at the desired wavelengths via the application of signal processing to the white light generally used by endoscopes [13][14]. However, given the limited ability of conventional white light illumination to achieve high-cotrast imaging of microvessels in the mucosal surface layer, a more effective system was needed.…”