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

Journal of Gastroenterology volume 44, Article number: 1125 (2009) Cite this article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

FICE:

Flexible spectral imaging color enhancement

BE:

Barrett’s esophagus

GEJ:

Gastroesophageal junction

NBI:

Narrow band imaging

EGD:

Esophagogastroduodenoscopy

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Acknowledgments

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

Author information

Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Hiroyuki Osawa, Hironori Yamamoto, Mitsuyo Yoshizawa, Keijiro Sunada, Hironari Ajibe, Kiichi Satoh & Kentaro Sugano

  2. Yamada Internal Medicine and Neurosurgery Clinic, Tochigi, Japan

    Naoshi Yamada

  3. Department of Gastroenterology, Saitama Medical University, International Medical Center, Saitama, Japan

    Hiroto Kita

Authors
  1. Hiroyuki Osawa
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  2. Hironori Yamamoto
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  3. Naoshi Yamada
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  4. Mitsuyo Yoshizawa
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  5. Keijiro Sunada
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  6. Hiroto Kita
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  7. Hironari Ajibe
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  8. Kiichi Satoh
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  9. Kentaro Sugano
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Corresponding author

Correspondence to Hiroyuki Osawa.

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Osawa, H., Yamamoto, H., Yamada, N. et al. Diagnosis of endoscopic Barrett’s esophagus by transnasal flexible spectral imaging color enhancement. J Gastroenterol 44, 1125 (2009). https://doi.org/10.1007/s00535-009-0121-z

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  • DOI: https://doi.org/10.1007/s00535-009-0121-z

Keywords

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