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Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

World Journal of Gastroenterology 2024年第14期30卷 1934-1940页

作者： Osamu Toyoshima Toshihiro Nishizawa Keisuke Hata Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic technique.This topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative diagnosis.Therefore,further studies on the efficacy of TXI in clinical practice are required.

关键词： Endoscopy Texture and color enhancement imaging white-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

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Comparative study on artificial intelligence systems for detecting early esophageal squamous cell carcinoma between narrow-band and white-light imaging

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World Journal of Gastroenterology 2021年第3期27卷 281-293页

作者： Bing Li Shi-Lun Cai Wei-Min Tan Ji-Chun Li Ayimukedisi Yalikong Xiao-Shuang Feng Hon-Ho Yu Pin-Xiang Lu Zhen Feng Li-Qing Yao Ping-Hong Zhou Bo Yan Yun-Shi Zhong Department of Endoscopy Center Zhongshan Hospital of Fudan UniversityShanghai 200032China School of Computer Science Fudan UniversityShanghai 200433China Clinical Statistical Center Shanghai Cancer Center of Fudan UniversityShanghai 200032China Department of Gastroenterology Kiang Wu HospitalMacao SAR 999078China Department of Endoscopy Center Xuhui HospitalZhongshan Hospital of Fudan UniversityShanghai 200031China

BACKGROUND Non-magnifying endoscopy with narrow-band imaging(NM-NBI)has been frequently used in routine screening of esophagus squamous cell carcinoma(ESCC).The performance of NBI for screening of early ESCC is,however,significantly affected by operator experience.Artificial intelligence may be a unique approach to compensate for the lack of operator experience.AIM To construct a computer-aided detection(CAD)system for application in NMNBI to identify early ESCC and to compare it with our previously reported CAD system with endoscopic white-light imaging(WLI).METHODS A total of 2167 abnormal NM-NBI images of early ESCC and 2568 normal images were collected from three institutions(Zhongshan Hospital of Fudan University,Xuhui Hospital,and Kiang Wu Hospital)as the training dataset,and 316 pairs of images,each pair including images obtained by WLI and NBI(same part),were collected for validation.Twenty endoscopists participated in this study to review the validation images with or without the assistance of the CAD systems.The diagnostic results of the two CAD systems and improvement in diagnostic efficacy of endoscopists were compared in terms of sensitivity,specificity,accuracy,positive predictive value,and negative predictive value.RESULTS The area under receiver operating characteristic curve for CAD-NBI was 0.9761.For the validation dataset,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CAD-NBI were 91.0%,96.7%,94.3%,95.3%,and 93.6%,respectively,while those of CAD-WLI were 98.5%,83.1%,89.5%,80.8%,and 98.7%,respectively.CAD-NBI showed superior accuracy and specificity than CAD-WLI(P=0.028 and P≤0.001,respectively),while CAD-WLI had higher sensitivity than CAD-NBI(P=0.006).By using both CAD-WLI and CAD-NBI,the endoscopists could improve their diagnostic efficacy to the highest level,with accuracy,sensitivity,and specificity of 94.9%,92.4%,and 96.7%,respectively.CONCLUSION The CAD-NBI system for screening early ESCC has higher accuracy and specificity than CAD-WLI.End

关键词： Computer-aided detection Esophageal squamous cell carcinoma Endoscopy Screening Narrow-band imaging white-light imaging

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Efficacy of image-enhanced endoscopy for colorectal adenoma detection:A multicenter,randomized trial

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World Journal of Gastrointestinal Oncology 2023年第5期15卷 878-891页

作者： Zhi-Peng Qi En-Pan Xu Dong-Li He Yan Wang Bai-Sheng Chen Xue-Si Dong Qiang Shi Shi-Lun Cai Qi Guo Ni Li Xing Li Hai-Yan Huang Bing Li Di Sun Jian-Guang Xu Zhang-Han Chen Ayimukedisi Yalikong Jin-Yi Liu Zhen-Tao Lv Jian-Min Xu Ping-Hong Zhou Yun-Shi Zhong Endoscopy Center Zhongshan Hospital of Fudan UniversityShanghai 200030China Endoscopy Center Shanghai Xuhui Central HospitalShanghai 200030China Endoscopy Center Traditional Chinese Medical HospitalRongcheng 264300Shandong ProvinceChina Department of Endoscopy Center Xiamen Branch of Affiliated Zhongshan Hospital of Fudan UniversityXiamen 361000Fujian ProvinceChina Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000China Department of Gastroenterology Pingxiang People’s HospitalPingxiang 337000Jiangxi ProvinceChina Department of Clinical Medicine Xiaogang HospitalNingbo 315000Zhejiang ProvinceChina Endoscopy Center Quzhou People’s HospitalQuzhou 324000Zhejiang ProvinceChina Department of General Surgery Zhongshan Hospital of Fudan UniversityShanghai 200030China

BACKGROUND Improved adenoma detection at colonoscopy has decreased the risk of developing colorectal cancer.However,whether image-enhanced endoscopy(IEE)further improves the adenoma detection rate(ADR)is controversial.AIM To compare IEE with white-light imaging(WLI)endoscopy for the detection and identification of colorectal adenoma.METHODS This was a multicenter,randomized,controlled trial.Participants were enrolled between September 2019 to April 2021 from 4 hospital in China.Patients were randomly assigned to an IEE group with WLI on entry and IEE on withdrawal(n=2113)or a WLI group with WLI on both entry and withdrawal(n=2098).The primary outcome was the ADR.The secondary endpoints were the polyp detection rate(PDR),adenomas per colonoscopy,adenomas per positive colonoscopy,and factors related to adenoma detection.RESULTS A total of 4211 patients(966 adenomas)were included in the analysis(mean age,56.7 years,47.1%male).There were 2113 patients(508 adenomas)in the IEE group and 2098 patients(458 adenomas)in the WLI group.The ADR in two group were not significantly different[24.0%vs 21.8%,1.10,95%confidence interval(CI):0.99-1.23,P=0.09].The PDR was higher with IEE group(41.7%)than with WLI group(36.1%,1.16,95%CI:1.07-1.25,P=0.01).Differences in mean withdrawal time(7.90±3.42 min vs 7.85±3.47 min,P=0.30)and adenomas per colonoscopy(0.33±0.68 vs 0.28±0.62,P=0.06)were not significant.Subgroup analysis found that with narrowband imaging(NBI),between-group differences in the ADR,were not significant(23.7%vs 21.8%,1.09,95%CI:0.97-1.22,P=0.15),but were greater with linked color imaging(30.9%vs 21.8%,1.42,95%CI:1.04-1.93,P=0.04).the second-generation NBI(2G-NBI)had an advantage of ADR than both WLI and the first-generation NBI(27.0%vs 21.8%,P=0.01;27.0%vs 21.2.0%,P=0.01).CONCLUSION This prospective study confirmed that,among Chinese,IEE didn’t increase the ADR compared with WLI,but 2G-NBI increase the ADR.

关键词： Endoscopy Image-enhanced endoscopy Adenoma detection rate white-light imaging Narrowband imaging

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A novel intelligent chromo capsule endoscope for the diagnosis of neoplastic lesions in the gastrointestinal tract

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Gastroenterology Report 2023年第1期11卷 291-299页

作者： Huiying Shi Suya Pang Fanhua Ming Tianyi Yangdai Shuxin Tian Rong Lin Department of Gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiP.R.China Ankon Technologies Co. LtdWuhanHubeiP.R.China Department of Gastroenterology The First Affiliated Hospital of Medical CollegeShihezi UniversityShiheziXinjiangP.R.China

Background:Chromoendoscopy has not been fully integrated into capsule endoscopy.This study aimded to develop and validate a novel intelligent chromo capsule endoscope(ICCE).Methods:The ICCE has two modes:a white-light imaging(WLI)mode and an intelligent chromo imaging(ICI)mode.The performance of the ICCE in observing colors,animal tissues,and early gastrointestinal(GI)neoplastic lesions in humans was evaluated.Images captured by the ICCE were analysed using variance of Laplacian(VoL)values or image contrast evaluation.Results:For color observation,conventional narrow-band imaging endoscopes and the ICI mode of the ICCE have similar spectral distributions.Compared with the WLI mode,the ICI mode had significantly higher VoL values for animal tissues(2.15461.044 vs 3.80061.491,P=0.003),gastric precancerous lesions and early gastric cancers(2.24260.162 vs 6.64260.919,P<0.001),and colon tumors(3.89661.430 vs 11.88267.663,P<0.001),and significantly higher contrast for differentiating tumor and non-tumor areas(0.06960.046 vs 0.14460.076,P=0.005).More importantly,the sensitivity,specificity,and accuracy of the ICI mode for early GI tumors were 95.83%,91.67%,and 94.64%,respectively,which were significantly higher than the values of the WLI mode(78.33%[P<0.001],77.08%[P=0.01],and 77.98%[P<0.001],respectively).Conclusions:We successfully integrated ICI into the capsule endoscope.The ICCE is an innovative and useful tool for differential diagnosis based on contrast-enhanced images and thus has great potential as a superior diagnostic tool for early GI tumor detection.

关键词： capsule endoscopy chromoendoscopy intelligent chromo capsule endoscope white-light imaging intelligent chromo imaging

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