Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images

Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies...

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Main Authors: Riccardo Vasapolli, Johannes Raphael Westphal, Christian Schulz
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1925
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author Riccardo Vasapolli
Johannes Raphael Westphal
Christian Schulz
author_facet Riccardo Vasapolli
Johannes Raphael Westphal
Christian Schulz
author_sort Riccardo Vasapolli
collection DOAJ
description Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis.
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spelling doaj-art-e21c5af17e47496f86c8e9bbc9d57d162025-08-20T03:36:31ZengMDPI AGDiagnostics2075-44182025-07-011515192510.3390/diagnostics15151925Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative ImagesRiccardo Vasapolli0Johannes Raphael Westphal1Christian Schulz2Medical Department II, University Hospital LMU Munich, 81377 Munich, GermanyMedical Department II, University Hospital LMU Munich, 81377 Munich, GermanyMedical Department II, University Hospital LMU Munich, 81377 Munich, GermanyChronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis.https://www.mdpi.com/2075-4418/15/15/1925endocytoscopystomachpreneoplastic lesionsintestinal metaplasiagastric atrophygastric cancer
spellingShingle Riccardo Vasapolli
Johannes Raphael Westphal
Christian Schulz
Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
Diagnostics
endocytoscopy
stomach
preneoplastic lesions
intestinal metaplasia
gastric atrophy
gastric cancer
title Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
title_full Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
title_fullStr Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
title_full_unstemmed Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
title_short Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
title_sort texture and color enhancement imaging assisted endocytoscopy improves characterization of gastric precancerous conditions a set of interesting comparative images
topic endocytoscopy
stomach
preneoplastic lesions
intestinal metaplasia
gastric atrophy
gastric cancer
url https://www.mdpi.com/2075-4418/15/15/1925
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AT johannesraphaelwestphal textureandcolorenhancementimagingassistedendocytoscopyimprovescharacterizationofgastricprecancerousconditionsasetofinterestingcomparativeimages
AT christianschulz textureandcolorenhancementimagingassistedendocytoscopyimprovescharacterizationofgastricprecancerousconditionsasetofinterestingcomparativeimages