Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
Abstract Objectives Recently, the incidence of Helicobacter pylori‐uninfected gastric cancers, such as gastric epithelial neoplasm of fundic‐gland mucosa lineage (GEN‐FGML), has increased with the widespread use of eradication therapy. Because the detection and endoscopic diagnosis of GEN‐FGML are d...
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| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-04-01
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| Series: | DEN Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/deo2.70110 |
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| Summary: | Abstract Objectives Recently, the incidence of Helicobacter pylori‐uninfected gastric cancers, such as gastric epithelial neoplasm of fundic‐gland mucosa lineage (GEN‐FGML), has increased with the widespread use of eradication therapy. Because the detection and endoscopic diagnosis of GEN‐FGML are difficult, an effective observation method in screening endoscopy is required. We investigated whether texture and color enhancement imaging (TXI) improved the visibility of GEN‐FGML compared with white light imaging (WLI). Methods In this single‐center prospective clinical study, 50 GEN‐FGML lesions (35 patients) treated at our hospital between October 2020 and June 2023 were analyzed. The endoscopic images of GEN‐FGML obtained using WLI, TXI mode 1 (TXI‐1), TXI mode 2 (TXI‐2), and narrow‐band imaging were compared by 10 endoscopists. We analyzed the visibility score and inter‐rater reliability (intraclass correlation coefficient and conducted an objective evaluation based on L* a* b* color values and the color difference (ΔE*) in the CIE LAB color space system. Results Histologically, GEN‐FGML was classified as gastric adenocarcinoma of fundic‐gland type (n = 45) and gastric adenocarcinoma of fundic‐gland mucosa type (n = 5). The total visibility score for all endoscopists was significantly higher for TXI than for WLI (p < 0.01); and for TXI‐1 than for TXI‐2 (p < 0.01). The intraclass correlation coefficients for TXI‐1 and TXI‐2 were “almost perfect” and “substantial,” respectively, for all endoscopists. ΔE* was significantly higher for TXI than for WLI (p < 0.01). Conclusions TXI improved the visibility of GEN‐FGML for all endoscopists compared with WLI when evaluated subjectively and objectively. |
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| ISSN: | 2692-4609 |