Journal of Gastroenterology

, 44:1125 | Cite as

Diagnosis of endoscopic Barrett’s esophagus by transnasal flexible spectral imaging color enhancement

  • Hiroyuki OsawaEmail author
  • Hironori Yamamoto
  • Naoshi Yamada
  • Mitsuyo Yoshizawa
  • Keijiro Sunada
  • Hiroto Kita
  • Hironari Ajibe
  • Kiichi Satoh
  • Kentaro Sugano
Original Article—Alimentary Tract



The diagnosis of endoscopic Barrett’s esophagus (BE) has been under discussion for the past decade because palisade vessels may be obscured by inflammation or the location of upper end of gastric fold may be diversely changed. The flexible spectral imaging color enhancement (FICE) system can reconstruct improved spectral images decomposed from ordinary endoscopic images with free selection of three wavelengths, and can provide non-magnified images with high light intensity.


To evaluate whether the transnasal FICE system enables easier diagnosis of endoscopic BE, 72 patients with endoscopic BE were observed prospectively with a transnasal endoscope using both conventional images and FICE images. The visualization of palisade vessels and the identification of the demarcation between endoscopic BE mucosa and gastric mucosa were compared between FICE images and conventional endoscopic images, and the CIELAB color differences were calculated among palisade vessels, background BE mucosa and gastric folds.


Palisade vessels could be more clearly visualized in BE mucosa with transnasal FICE than with conventional endoscopy. Demarcation between whitish BE mucosa and the upper end of the brownish gastric mucosa could be clearly identified using transnasal FICE images. Greater color differences existed with FICE images between palisade vessels and background BE mucosa as well as between BE mucosa and gastric folds than with conventional images, leading to better contrasting images.


The transnasal FICE system enables clear visualization of palisade vessels and provides better contrasting images of the demarcation between the BE mucosa and the gastric mucosa, and thus contributes to easier diagnosis of endoscopic BE.


Flexible spectral imaging color enhancement Endoscopic Barrett’s esophagus Extent of Barrett’s esophagus Color difference 



Flexible spectral imaging color enhancement


Barrett’s esophagus


Gastroesophageal junction


Narrow band imaging





We are grateful to Mr. Ryo Takahashi for his work with the calculation of color difference.


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Copyright information

© Springer 2009

Authors and Affiliations

  • Hiroyuki Osawa
    • 1
    Email author
  • Hironori Yamamoto
    • 1
  • Naoshi Yamada
    • 2
  • Mitsuyo Yoshizawa
    • 1
  • Keijiro Sunada
    • 1
  • Hiroto Kita
    • 3
  • Hironari Ajibe
    • 1
  • Kiichi Satoh
    • 1
  • Kentaro Sugano
    • 1
  1. 1.Division of Gastroenterology, Department of Internal MedicineJichi Medical UniversityTochigiJapan
  2. 2.Yamada Internal Medicine and Neurosurgery ClinicTochigiJapan
  3. 3.Department of GastroenterologySaitama Medical University, International Medical CenterSaitamaJapan

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