The Magnified Endoscopic Finding of an Irregular Microvascular Pattern is a Very Useful Marker for Differentiating Between Gastritis and Gastric Cancer: A Prospective Study

Yao, Kenshi; Iwashita, Akinori; Matsui, Toshiyuki; Yao, Tsuneyoshi; Ikeda, Keisuke; Takagi, Yasuhiro; Kikuchi, Y.; Yorioka, Makoto; Kikuma, Kanta

doi:10.1016/s0016-5107(04)00806-5

Cited by 4 publications

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“…On the other hand, undifferentiated carcinomas demonstrated the disappearance of or a reduction in the regular SECN pattern. Magnification endos− copy findings for differentiated carcinoma could be useful for identifying the margin of the carcinoma for endoscopic mucosal resection [15], and may be helpful in distinguishing flat carcino− mas from gastritis in the case of flat reddened lesions detected by ordinary endoscopy [16]. As shown in Figure 6, the adaptive IHb color−enhancement technique provides benefits, especially with regard to the correct evaluation of irregular microvessels which proliferate densely within the carcinomatous tissue.…”

Section: Clinical Applications Of Adaptive Ihb Color Enhancement (Imamentioning

confidence: 99%

Techniques Using the Hemoglobin Index of the Gastric Mucosa

Yao¹,

Kato²,

Fujisaki³

2005

Endoscopy

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ObjectivesColor changes seen at endoscopy are important for gastrointesti− nal endoscopic diagnosis. Quantification of the color information is useful for a scientific assessment of endoscopic color images. Since hemoglobin is the predominant pigment in the gastroin− testinal mucosa, measurement of the hemoglobin content is a reasonable method for quantifying the color in gastrointestinal endoscopic images. Recently, Tsuji et al. have developed a tech− nique for measuring mucosal hemoglobin content using electro− nic endoscopic imaging data [1]. The measure is called the "index of hemoglobin" (IHb). In this article, we describe the clinical ap− plications and the usefulness of the technique. Currently, the technique is being used for two main purposes: image analysis and image processing, as shown in Table 1. Basic PrinciplesElectronic Endoscopy System with Red, Green, and Blue Se− quential Imaging In order to calculate the IHb, an electronic endoscopy system that uses red, blue, and green (RGB) sequential imaging is neces− sary ( Figure 1) [2]. Briefly, when the RGB sequential videoscope is used, the gastrointestinal mucosa is illuminated with red, green, and blue light in turn, through a rotating RGB filter wheel. A monochromatic charge−coupled device (CCD) incorporated into the distal tip of the scope detects the light reflected from the mucosa as corresponding signals (V r for red light, V g for green, and V b for blue light) and this information is stored in the memory of the processor. A color image is constructed from the three sequential signals, V r , V g and V b , and it is displayed on the color monitor. Calculation of the IHbThe IHb is calculated from the values of the V r and V g signals, based on the following rationale [1]. Hemoglobin is the predomi− nant pigment in the gastrointestinal mucosa. The peak absorp− tion of light by hemoglobin occurs at a wavelength of 560 nm (which is within the wavelength range of the V g signal), while there is low absorption by hemoglobin around the wavelength 650 nm (which is within the V r range). Thus, if the mucosa is rich in hemoglobin content, absorption of light at a wavelength of 560 nm is large, that is, V g is low, whereas if the mucosa is less rich in hemoglobin content, then absorption at 560 nm is small, that is, V g is high. On the other hand, irrespective of the he− moglobin content, V r tends to be constant. Accordingly, the loga− rithmic transformation of the ratio of V r to V g leads to an index which is correlated to the hemoglobin content of the mucosa. The IHb is calculated using the equation: IHb = 32[log 2 (V r /V g )]Principle of the Adaptive IHb Color−Enhancement Technique [3] Enhancement of differences in color in the endoscopic image might help the endoscopist to identify the presence or extent of a flat lesion which shows only a slight color change. A structure− enhancement technique that has been incorporated into the EVIS240 and EVIS260 systems can demonstrate mucosal struc− tural change more clearly, but it is not suitable for enhancin...

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Section: Clinical Applications Of Adaptive Ihb Color Enhancement (Imamentioning

confidence: 99%

Techniques Using the Hemoglobin Index of the Gastric Mucosa

Yao¹,

Kato²,

Fujisaki³

2005

Endoscopy

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“…While the characteristics of pale lesions that are suspected to contain SRCC can be challenging to define, it is important to establish such criteria as lesions with a similar appearance will accumulate with continued surveillance due to scarring of the gastric mucosa after repeated biopsy. Previous studies have indicated that pale patches with an irregular microvasculature and microsurface may be indicative of underlying SRCC ( 17 , 18 ). Building off this, the authors of the current study identified three additional criteria, including that pale lesions associated with SRCC are more round (rather than irregularly shaped), have well-defined borders, and are likely to be persistently observed from multiple different viewing angles as well as multiple viewing distances ( Figure 1 ) ( 14 ).…”

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confidence: 99%