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: Hisanori Utsunomiya, Hiroya Ueyama, Tsutomu Takeda, Shunsuke Nakamura, Yasuko Uemura, Tomoyo Iwano, Momoko Yamamoto, Ryota Uchida, Daiki Abe, Shotaro Oki, Nobuyuki Suzuki, Atsushi Ikeda, Yoichi Akazawa, Kumiko Ueda, Mariko Hojo, Shuko Nojiri, Takashi Yao, Akihito Nagahara
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.70110
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author Hisanori Utsunomiya
Hiroya Ueyama
Tsutomu Takeda
Shunsuke Nakamura
Yasuko Uemura
Tomoyo Iwano
Momoko Yamamoto
Ryota Uchida
Daiki Abe
Shotaro Oki
Nobuyuki Suzuki
Atsushi Ikeda
Yoichi Akazawa
Kumiko Ueda
Mariko Hojo
Shuko Nojiri
Takashi Yao
Akihito Nagahara
author_facet Hisanori Utsunomiya
Hiroya Ueyama
Tsutomu Takeda
Shunsuke Nakamura
Yasuko Uemura
Tomoyo Iwano
Momoko Yamamoto
Ryota Uchida
Daiki Abe
Shotaro Oki
Nobuyuki Suzuki
Atsushi Ikeda
Yoichi Akazawa
Kumiko Ueda
Mariko Hojo
Shuko Nojiri
Takashi Yao
Akihito Nagahara
author_sort Hisanori Utsunomiya
collection DOAJ
description 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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spelling doaj-art-10bca88c975f42e18071bced94b6d1682025-08-20T03:13:36ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70110Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imagingHisanori Utsunomiya0Hiroya Ueyama1Tsutomu Takeda2Shunsuke Nakamura3Yasuko Uemura4Tomoyo Iwano5Momoko Yamamoto6Ryota Uchida7Daiki Abe8Shotaro Oki9Nobuyuki Suzuki10Atsushi Ikeda11Yoichi Akazawa12Kumiko Ueda13Mariko Hojo14Shuko Nojiri15Takashi Yao16Akihito Nagahara17Department of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanMedical Technology Innovation Center Juntendo University School of Medicine Tokyo JapanDepartment of Human Pathology Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Gastroenterology Juntendo University School of Medicine Tokyo JapanAbstract 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.https://doi.org/10.1002/deo2.70110gastric adenocarcinoma of fundic‐gland mucosa typegastric adenocarcinoma of fundic‐gland typegastric epithelial neoplasm of fundic‐gland mucosa lineageoxyntic gland adenomatexture and color enhancement imaging
spellingShingle Hisanori Utsunomiya
Hiroya Ueyama
Tsutomu Takeda
Shunsuke Nakamura
Yasuko Uemura
Tomoyo Iwano
Momoko Yamamoto
Ryota Uchida
Daiki Abe
Shotaro Oki
Nobuyuki Suzuki
Atsushi Ikeda
Yoichi Akazawa
Kumiko Ueda
Mariko Hojo
Shuko Nojiri
Takashi Yao
Akihito Nagahara
Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
DEN Open
gastric adenocarcinoma of fundic‐gland mucosa type
gastric adenocarcinoma of fundic‐gland type
gastric epithelial neoplasm of fundic‐gland mucosa lineage
oxyntic gland adenoma
texture and color enhancement imaging
title Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
title_full Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
title_fullStr Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
title_full_unstemmed Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
title_short Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
title_sort visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
topic gastric adenocarcinoma of fundic‐gland mucosa type
gastric adenocarcinoma of fundic‐gland type
gastric epithelial neoplasm of fundic‐gland mucosa lineage
oxyntic gland adenoma
texture and color enhancement imaging
url https://doi.org/10.1002/deo2.70110
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