Third-Generation High-Vision Ultrathin Endoscopy Using Texture and Color Enhancement Imaging and Narrow-Band Imaging to Evaluate Barrett’s Esophagus

It remains unclear whether texture- and color-enhancement imaging (TXI) and narrow-band imaging (NBI) provide an advantage over white-light imaging (WLI) in Barrett’s esophagus. We compared endoscopic findings and color differences between WLI and image-enhanced endoscopy (IEE) using a third-generation ultrathin endoscope. We retrospectively enrolled 40 patients who evaluated Barrett’s esophagus using WLI, TXI, and NBI. Color differences determined using the International Commission on Illumination 1976 (L∗, a∗, b∗) color space among Barrett’s epithelium, esophageal, and gastric mucosa were compared among the endoscopic findings. As the secondary outcome, we assessed the subjective visibility score among three kinds of endoscopic findings. The prevalence of Barrett’s esophagus and gastroesophageal reflux disease (GERD) in WLI was 82.5% and 47.5%, respectively, and similar among WLI, TXI, and NBI. Color differences between Barrett’s epithelium and esophageal or gastric mucosa on NBI were significantly greater than on WLI (all p < 0.05). However, the color difference between Barrett’s epithelium and esophageal mucosa was significantly greater on NBI than TXI (p < 0.001), and the visibility score of Barrett’s epithelium detection was significantly greater on TXI than NBI (p = 0.022), and WLI (p = 0.016). High-vision, third-generation ultrathin endoscopy using NBI and TXI is useful for evaluating Barrett’s epithelium and GERD compared with WLI alone.

[1]  T. Itoi,et al.  Efficacy of high-vision transnasal endoscopy using texture and colour enhancement imaging and narrow-band imaging to evaluate gastritis: a randomized controlled trial , 2022, Annals of medicine.

[2]  T. Itoi,et al.  Efficacy of a Third-Generation High-Vision Ultrathin Endoscope for Evaluating Gastric Atrophy and Intestinal Metaplasia in Helicobacter pylori-Eradicated Patients , 2022, Journal of clinical medicine.

[3]  Yutaka Saito,et al.  Emerging texture and color enhancement imaging in early gastric cancer , 2021, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[4]  M. Suka,et al.  Texture and Color Enhancement Imaging Increases Color Changes and Improves Visibility for Squamous Cell Carcinoma Suspicious Lesions in the Pharynx and Esophagus , 2021, Diagnostics.

[5]  J. Devière,et al.  Pristine submucosal visibility using Texture and Color Enhancement Imaging during saline-immersion rectal endoscopic submucosal dissection , 2021, Endoscopy.

[6]  I. Oda,et al.  Visibility of early gastric cancer in texture and color enhancement imaging , 2021, DEN open.

[7]  Tomoya Sato,et al.  TXI: Texture and Color Enhancement Imaging for Endoscopic Image Enhancement , 2021, Journal of healthcare engineering.

[8]  N. Kato,et al.  Efficacy of Texture and Color Enhancement Imaging in visualizing gastric mucosal atrophy and gastric neoplasms , 2021, Scientific Reports.

[9]  T. Kawano,et al.  Linked Color Imaging Focused on Neoplasm Detection in the Upper Gastrointestinal Tract , 2020, Annals of Internal Medicine.

[10]  N. Ishimura,et al.  Prevalence of Barrett's Epithelium Shown by Endoscopic Observations with Linked Color Imaging in Subjects with Different H. pylori Infection Statuses , 2020, Internal medicine.

[11]  N. Mostafavi,et al.  Blue-light imaging and linked-color imaging improve visualization of Barrett's neoplasia by nonexpert endoscopists. , 2020, Gastrointestinal endoscopy.

[12]  Y. Naito,et al.  Linked color imaging identifies important risk factors associated with gastric cancer after successful Helicobacter pylori eradication. , 2019, Gastrointestinal endoscopy.

[13]  K. Koike,et al.  Artificial intelligence versus expert endoscopists for diagnosis of gastric cancer in patients who have undergone upper gastrointestinal endoscopy , 2019, Endoscopy.

[14]  A. Meining,et al.  Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study. , 2019, Gastrointestinal endoscopy.

[15]  Y. Naito,et al.  Blue laser imaging-bright improves the real-time detection rate of early gastric cancer: a randomized controlled study. , 2019, Gastrointestinal endoscopy.

[16]  Mototsugu Kato,et al.  Lavender Color in Linked Color Imaging Enables Noninvasive Detection of Gastric Intestinal Metaplasia , 2018, Digestion.

[17]  Sumio Watanabe,et al.  Improved Visibility of Barrett’s Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis , 2018, Digestion.

[18]  K. Murakami,et al.  Objective Endoscopic Analysis with Linked Color Imaging regarding Gastric Mucosal Atrophy: A Pilot Study , 2017, Gastroenterology research and practice.

[19]  C. Hassan,et al.  Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement , 2017, Endoscopy.

[20]  Japan Esophageal Society.  Japanese Classification of Esophageal Cancer, 11th Edition: part I , 2016, Esophagus.

[21]  B. Enestvedt,et al.  ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus. , 2016, Gastrointestinal endoscopy.

[22]  Irving Waxman,et al.  Development and Validation of a Classification System to Identify High-Grade Dysplasia and Esophageal Adenocarcinoma in Barrett's Esophagus Using Narrow-Band Imaging. , 2016, Gastroenterology.

[23]  R. Takimoto,et al.  Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions , 2014, Endoscopy International Open.

[24]  H. Arakawa,et al.  Ultrathin endoscopy versus high-resolution endoscopy for diagnosing superficial gastric neoplasia. , 2009, Gastrointestinal endoscopy.

[25]  Revital Kariv,et al.  The Seattle protocol does not more reliably predict the detection of cancer at the time of esophagectomy than a less intensive surveillance protocol. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[26]  M. Hongo,et al.  Epidemiology of esophageal cancer: Orient to Occident. Effects of chronology, geography and ethnicity , 2009, Journal of gastroenterology and hepatology.

[27]  J. Everhart,et al.  Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. , 2009, Gastroenterology.

[28]  T. Tani,et al.  Feasibility and tolerance of 2-way and 4-way angulation videoscopes for unsedated patients undergoing transnasal EGD in GI cancer screening. , 2008, Gastrointestinal endoscopy.

[29]  M. Hongo,et al.  It Is Possible to Classify Non-erosive Reflux Disease (NERD) Patients into Endoscopically Normal Groups and Minimal Change Groups by Subjective Symptoms and Responsiveness to Rabeprazole—A Report from a Study with Japanese Patients , 2008, Digestive Diseases and Sciences.

[30]  S. Roman,et al.  Prospective evaluation of a new ultrathin one-plane bending videoendoscope for transnasal EGD: a comparative study on performance and tolerance. , 2007, Gastrointestinal endoscopy.

[31]  M. Hongo.  Minimal changes in reflux esophagitis: red ones and white ones , 2006, Journal of Gastroenterology.

[32]  O. Kawamura,et al.  Development and evaluation of FSSG: frequency scale for the symptoms of GERD , 2004, Journal of Gastroenterology.

[33]  Y. Kinoshita,et al.  Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly , 2001, Journal of gastroenterology and hepatology.

[34]  J R Bennett,et al.  The endoscopic assessment of esophagitis: a progress report on observer agreement. , 1996, Gastroenterology.

[35]  R. Kuehni.  Color-tolerance data and the tentative CIE 1976 L a b formula. , 1976, Journal of the Optical Society of America.

[36]  Y. Kinoshita,et al.  Abdominal symptom-related QOL in individuals visiting an outpatient clinic and those attending an annual health check. , 2011, Internal medicine.