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Objective: There are little data regarding the efficacy of texture and color enhancement imaging (TXI) for early gastric cancer (EGC) diagnosis. This study aimed to compare the color difference and visibility of EGC between white light imaging (WLI) and TXI.
Methods: This study included 20 EGCs of 18 patients undergoing endoscopic submucosal dissection. Still images of EGC in WLI, TXI mode 1 (with color enhancement), and TXI mode 2 (without color enhancement), which were consistent in distance, angle, and air insufflation, were constructed by computer simulation. The center of the lesion, eight equal peripheral points 5 mm outside the lesion, and eight inner points two-thirds of the distance from peripheral points to the EGC lesion center were annotated. Mean color differences (ΔE) of the area between peripheral and inner points per lesion in WLI, TXI mode 1, and TXI mode 2 were analyzed. In addition, four endoscopists independently scored the visibility of EGC images of TXI mode 1 and 2 compared with WLI.
Results: Clinicopathological characteristics were as follows: 0-IIa/0-IIb/0-IIc/0-IIa+IIc = 6/1/11/2, reddish/pale = 10/10, differentiated/undifferentiated = 18/2, median tumor size = 13.5 mm. Mean ΔE ± SD = WLI/TXI mode1/TXI mode2 = 10.3 ± 4.7, 15.5 ± 7.8, and 12.7 ± 6.1, respectively. Mean ΔE was significantly higher in TXI mode 1 than in WLI. Visibility (improved/no change/decreased) was 7/13/0 and 4/16/0 in TXI mode 1 and 2, respectively. The visibility was significantly more commonly improved in the macroscopic type 0-IIc or 0-IIb than in 0-IIa or IIa+IIc in TXI mode 1.
Conclusions: TXI could improve the visibility of EGC compared with WLI.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8828244 | PMC |
http://dx.doi.org/10.1002/deo2.46 | DOI Listing |
Dig Endosc
August 2025
Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Objective: To reveal the efficacy of texture and color enhancement imaging (TXI), which highlights changes in the brightness, color, and texture of colorectal polyps, we conducted a prospective crossover randomized trial.
Methods: Between June 2022 and January 2023, 700 consecutive patients who underwent colonoscopy were randomly assigned (1:1) to the TXI or white-light imaging (WLI) groups. After the first inspection of the right colon, the endoscope was reinserted into the cecum, and a second inspection was performed using another mode.
Diagnostics (Basel)
July 2025
Medical Department II, University Hospital LMU Munich, 81377 Munich, Germany.
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.
View Article and Find Full Text PDFObjectives: A 'gray color sign' (GCS) is a new endoscopic feature of fundic gland polyp associated with proton pump inhibitor (PPI-FGP). Here, we compare the ability of texture and color enhancement imaging (TXI) to white light imaging (WLI) with regard to the detection of GCS.
Methods: In this prospective study, 19 consecutive patients with PPI-FGP were enrolled at our hospital from April 2021 to October 2022.
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).
View Article and Find Full Text PDFGastroenterology
August 2025
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. Electronic address:
Background & Aims: Colonoscopy is the gold standard for detecting and resecting adenomas and early-stage cancers to reduce colorectal cancer (CRC) incidence and mortality rates. This study aimed to confirm the superiority of texture and color enhancement imaging (TXI) over white light imaging (WLI) in detecting colorectal lesions.
Methods: This randomized controlled trial was conducted at 8 Japanese institutions between March 2023 and October 2023.