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Nakazawa K, Nouda S, Kakimoto K, Kinoshita N, Tanaka Y, Tawa H, Koshiba R, Naka Y, Hirata Y, Ota K, Kawakami K, Takeuchi T, Inoue T, Miyazaki T, Sanomura M, Nakamura S, Saito Y, Higuchi K. The Differential Diagnosis of Colorectal Polyps Using Colon Capsule Endoscopy. Intern Med 2021; 60:1805-1812. [PMID: 33456043 PMCID: PMC8263190 DOI: 10.2169/internalmedicine.6446-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022] Open
Abstract
Objective Although colorectal polyps (CPs) can be observed with colon capsule endoscopy (CCE), it is difficult to determine the type of polyp using CCE. The objective of this study was to differentiate adenomatous polyps (APs) from hyperplastic polyps (HPs) with CCE. Methods In this single-center retrospective study, an analysis was conducted on the same CPs with both CCE and colonoscopy (CS) and histopathologically diagnosed as AP or HP. The color difference (ΔE) between the polyp surface and the surrounding mucosa was calculated using the CIE1976 L*a*b* color space method on white light (WL), flexible spectral imaging color enhancement (FICE), and blue mode (BM) CP images. We investigated the ability of the ratio of the color differences (ΔE') to differentiate between APs and HPs. Results The size of all 51 polyps (34 APs, 17 HPs) was 7.5±4.6 mm with CCE and 7.3±4.2 mm with CS, and this difference was not significant (p=0.28). The FICEΔE' of APs was 3.3±1.8, which was significantly higher than the FICEΔE' of HPs (1.3±0.6; p<0.001). A receiver operating characteristic analysis showed that FICEΔE' was useful for differentiating between APs and HPs, with an area under the curve of 0.928 (95% confidence interval, 0.843-1). The sensitivity was 91.2%, and the specificity was 88.2% with a cut-off value of 1.758. Conclusion Using FICE on CCE images of CPs and applying the CIELAB color space method, we were able to differentiate between APs and HPs with high accuracy. This method has the potential to reduce unnecessary CS procedures.
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Affiliation(s)
- Kei Nakazawa
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
- Endoscopy Division, National Cancer Center Hospital, Japan
| | - Sadaharu Nouda
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Kazuki Kakimoto
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | | | - Yasuyoshi Tanaka
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Hideki Tawa
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Ryoji Koshiba
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Yutaka Naka
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Yuki Hirata
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Kazuhiro Ota
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Ken Kawakami
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | | | - Takuya Inoue
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Takako Miyazaki
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Makoto Sanomura
- Department of Gastroenterology, Hokusetsu General Hospital, Japan
| | - Shiro Nakamura
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Japan
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He Z, Wang P, Liang Y, Fu Z, Ye X. Clinically Available Optical Imaging Technologies in Endoscopic Lesion Detection: Current Status and Future Perspective. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7594513. [PMID: 33628407 PMCID: PMC7886528 DOI: 10.1155/2021/7594513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/13/2021] [Accepted: 01/27/2021] [Indexed: 01/02/2023]
Abstract
Endoscopic optical imaging technologies for the detection and evaluation of dysplasia and early cancer have made great strides in recent decades. With the capacity of in vivo early detection of subtle lesions, they allow modern endoscopists to provide accurate and effective optical diagnosis in real time. This review mainly analyzes the current status of clinically available endoscopic optical imaging techniques, with emphasis on the latest updates of existing techniques. We summarize current coverage of these technologies in major hospital departments such as gastroenterology, urology, gynecology, otolaryngology, pneumology, and laparoscopic surgery. In order to promote a broader understanding, we further cover the underlying principles of these technologies and analyze their performance. Moreover, we provide a brief overview of future perspectives in related technologies, such as computer-assisted diagnosis (CAD) algorithms dealing with exploring endoscopic video data. We believe all these efforts will benefit the healthcare of the community, help endoscopists improve the accuracy of diagnosis, and relieve patients' suffering.
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Affiliation(s)
- Zhongyu He
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Peng Wang
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Yuelong Liang
- Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
| | - Zuoming Fu
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
| | - Xuesong Ye
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
- State Key Laboratory of CAD and CG, Zhejiang University, Hangzhou 310058, China
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Beg S, Wilson A, Ragunath K. The use of optical imaging techniques in the gastrointestinal tract. Frontline Gastroenterol 2016; 7:207-215. [PMID: 27429735 PMCID: PMC4941161 DOI: 10.1136/flgastro-2015-100563] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/15/2015] [Accepted: 05/19/2015] [Indexed: 02/04/2023] Open
Abstract
With significant advances in the management of gastrointestinal disease there has been a move from diagnosing advanced pathology, to detecting early lesions that are potentially amenable to curative endoscopic treatment. This has required an improvement in diagnostics, with a focus on identifying and characterising subtle mucosal changes. There is great interest in the use of optical technologies to predict histology and enable the formulation of a real-time in vivo diagnosis, a so-called 'optical biopsy'. The aim of this review is to explore the evidence for the use of the current commercially available imaging techniques in the gastrointestinal tract.
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Affiliation(s)
- Sabina Beg
- NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Queens Medical Centre Campus, Nottingham, UK
| | - Ana Wilson
- Department of Gastroenterology, Wolfson Unit for Endoscopy, St Mark's hospital, London, UK
| | - Krish Ragunath
- NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases at Nottingham University Hospitals NHS Trust and The University of Nottingham, Queens Medical Centre Campus, Nottingham, UK
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Sato Y, Sagawa T, Hirakawa M, Ohnuma H, Osuga T, Okagawa Y, Tamura F, Horiguchi H, Takada K, Hayashi T, Sato T, Miyanishi K, Takimoto R, Kobune M, Kato J. Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions. Endosc Int Open 2014; 2:E80-7. [PMID: 26135265 PMCID: PMC4423264 DOI: 10.1055/s-0034-1365526] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 02/12/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND STUDY AIMS The clinical utility of computed virtual chromoendoscopy with flexible spectral imaging color enhancement (FICE) in capsule endoscopy (CE) remains controversial. To clarify the clinical utility of FICE-enhanced CE in evaluating small bowel lesions, we quantitatively assessed white light (WL), FICE, and blue mode (BM) images and examined the sensitivity of these 3 imaging modes of small-bowel lesions from patients who underwent CE. METHODS The CIELAB color difference (∆E) and visual analogue scales (VAS) were measured in 261 CE images (3 different lesion categories) using WL and FICE set 1, 2, and 3, and BM images, respectively. Three endoscopists reviewed CE videos with WL, 3 FICE mode settings, and BM, and compared the sensitivity and detectability for small intestinal diseases from 50 patients who underwent CE. RESULTS In the assessment of visibility in the 152 vascular lesion images, the ∆E and VAS of FICE set 1, 2, and BM images were significantly higher than that of WL images. In 88 erosion/ulceration images, the ∆E and VAS of FICE set 1 and 2 images were significantly higher than that of WL images. In 21 tumor images, there were no significant differences in ∆E among these modalities. When analyzed on a per-patient basis, FICE settings 1 and 2 had the highest sensitivity (100 %) and specificity (97.3 - 100 %) for vascular lesions. As for erosive/ulcerative lesions, FICE setting 2 had the highest sensitivity (100 %) and specificity (97.2 %). For tumors or polyps, WL had the highest sensitivity (90.9 %) and specificity (87.1 %). In per-lesion analysis, FICE settings 1 and 2 showed significantly superior detection ability over WL for vascular lesions. In the detection of erosive/ulcerative lesions, FICE setting 2 was significantly superior to WL. In tumor images, there was no significant improvement with any of the settings relative to WL images. CONCLUSIONS FICE is most useful for improving CE image quality and detection in cases of angioectasia and erosion/ulceration of the small intestine.
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Affiliation(s)
- Yasushi Sato
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan,Corresponding author: Yasushi Sato Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical UniversitySouth 1 West 16, Chuo-kuSapporo 060-8543Japan
| | - Tamotsu Sagawa
- Division of Gastroenterology, Hokkaido Cancer Center, Sapporo, Japan
| | - Masahiro Hirakawa
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroyuki Ohnuma
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Takahiro Osuga
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yutaka Okagawa
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Fumito Tamura
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroto Horiguchi
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kohichi Takada
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tsuyoshi Hayashi
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tsutomu Sato
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Koji Miyanishi
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Rishu Takimoto
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Masayoshi Kobune
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Junji Kato
- Department of Medical Oncology and Hematology, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Cammarota G, Ianiro G, Sparano L, La Mura R, Ricci R, Larocca LM, Landolfi R, Gasbarrini A. Image-enhanced endoscopy with I-scan technology for the evaluation of duodenal villous patterns. Dig Dis Sci 2013; 58:1287-92. [PMID: 23108566 DOI: 10.1007/s10620-012-2467-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 10/11/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND I-scan technology is the newly developed endoscopic tool that works in real time and utilizes a digital contrast method to enhance endoscopic image. AIMS We performed a feasibility study aimed to determine the diagnostic accuracy of i-scan technology for the evaluation of duodenal villous patterns, having histology as the reference standard. METHODS In this prospective, single center, open study, patients undergoing upper endoscopy for an histological evaluation of duodenal mucosa were enrolled. All patients underwent upper endoscopy using high resolution view in association with i-scan technology. During endoscopy, duodenal villous patterns were evaluated and classified as normal, partial villous atrophy, or marked villous atrophy. Results were then compared with histology. RESULTS One hundred fifteen subjects were recruited in this study. The endoscopist was able to find marked villous atrophy of the duodenum in 12 subjects, partial villous atrophy in 25, and normal villi in the remaining 78 individuals. The i-scan system was demonstrated to have great accuracy (100 %) in the detection of marked villous atrophy patterns. I-scan technology showed quite lower accuracy in determining partial villous atrophy or normal villous patterns (respectively, 90 % for both items). CONCLUSIONS Image-enhancing endoscopic technology allows a clear visualization of villous patterns in the duodenum. By switching from the standard to the i-scan view, it is possible to optimize the accuracy of endoscopy in recognizing villous alteration in subjects undergoing endoscopic evaluation.
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Affiliation(s)
- Giovanni Cammarota
- Division of Gastroenterology, Endoscopy Unit, Catholic University of Medicine and Surgery, Rome, Italy.
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Abstract
BACKGROUND I-scan technology is the newly developed endoscopic tool that works in real time and utilizes a digital contrast method to enhance endoscopic image. AIMS We performed a feasibility study aimed to determine the diagnostic accuracy of i-scan technology for the evaluation of duodenal villous patterns, having histology as the reference standard. METHODS In this prospective, single center, open study, patients undergoing upper endoscopy for an histological evaluation of duodenal mucosa were enrolled. All patients underwent upper endoscopy using high resolution view in association with i-scan technology. During endoscopy, duodenal villous patterns were evaluated and classified as normal, partial villous atrophy, or marked villous atrophy. Results were then compared with histology. RESULTS One hundred fifteen subjects were recruited in this study. The endoscopist was able to find marked villous atrophy of the duodenum in 12 subjects, partial villous atrophy in 25, and normal villi in the remaining 78 individuals. The i-scan system was demonstrated to have great accuracy (100 %) in the detection of marked villous atrophy patterns. I-scan technology showed quite lower accuracy in determining partial villous atrophy or normal villous patterns (respectively, 90 % for both items). CONCLUSIONS Image-enhancing endoscopic technology allows a clear visualization of villous patterns in the duodenum. By switching from the standard to the i-scan view, it is possible to optimize the accuracy of endoscopy in recognizing villous alteration in subjects undergoing endoscopic evaluation.
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Kwon YS, Cho YS, Yoon TJ, Kim HS, Choi MG. Recent advances in targeted endoscopic imaging: Early detection of gastrointestinal neoplasms. World J Gastrointest Endosc 2012; 4:57-64. [PMID: 22442742 PMCID: PMC3309894 DOI: 10.4253/wjge.v4.i3.57] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 01/22/2012] [Accepted: 03/02/2012] [Indexed: 02/05/2023] Open
Abstract
Molecular imaging has emerged as a new discipline in gastrointestinal endoscopy. This technology encompasses modalities that can visualize disease-specific morphological or functional tissue changes based on the molecular signature of individual cells. Molecular imaging has several advantages including minimal damage to tissues, repetitive visualization, and utility for conducting quantitative analyses. Advancements in basic science coupled with endoscopy have made early detection of gastrointestinal cancer possible. Molecular imaging during gastrointestinal endoscopy requires the development of safe biomarkers and exogenous probes to detect molecular changes in cells with high specificity anda high signal-to-background ratio. Additionally, a high-resolution endoscope with an accurate wide-field viewing capability must be developed. Targeted endoscopic imaging is expected to improve early diagnosis and individual therapy of gastrointestinal cancer.
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Affiliation(s)
- Yong-Soo Kwon
- Yong-Soo Kwon, Tae-Jong Yoon, Department of Applied Bioscience, CHA University, Seoul 135081, South Korea
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Gerstner AOH, Laffers W, Bootz F, Farkas DL, Martin R, Bendix J, Thies B. Hyperspectral imaging of mucosal surfaces in patients. JOURNAL OF BIOPHOTONICS 2012; 5:255-62. [PMID: 22232073 DOI: 10.1002/jbio.201100081] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 12/13/2011] [Accepted: 12/19/2011] [Indexed: 05/24/2023]
Abstract
The aim of this study was to proof applicability of hyperspectral imaging for the analysis and classification of human mucosal surfaces in vivo. The larynx as a prototypical anatomically well-defined surgical test area was analyzed by microlaryngoscopy with a polychromatic lightsource and a synchronous triggered monochromatic CCD-camera. Image stacks (5 benign, 7 malignant tumors) were analyzed by established software (principal component analysis PCA, hyperspectral classification, spectral profiles). Hyperspectral image datacubes were analyzed and classified by conventional software. In PCA, images at 590-680 nm loaded most onto the first PC which typically contained 95% of the total information. Hyperspectral classification clustered the data highlighting altered mucosa. The spectral profiles clearly differed between the different groups. Hyperspectral imaging can be applied to mucosal surfaces. This approach opens the way to analyze spectral characteristics of histologically different lesions in order to build up a spectral library and to allow non-touch optical biopsy.
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Affiliation(s)
- Andreas O H Gerstner
- Dept. of Otorhinolaryngology/Head and Neck Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
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