Differences in color between early gastric cancer and cancer-suspected non-cancerous mucosa on linked color imaging - Abstract

Q: What is the study purpose regarding linked color imaging (LCI)?

To investigate how LCI color characteristics differ between early gastric cancer (EGC) and cancer-suspected non-cancerous mucosa (CSM).

Q: How were images and diagnoses evaluated in the retrospective analysis?

LCI images for EGC and CSM were collected from the institutional database, and 15 endoscopists individually judged each image. Color differences were quantified using CIE-Lab analysis for inside versus outside lesion regions.

Q: What did the results show about color differences between EGC and CSM?

The total color difference was almost the same, but color tones differed significantly: ΔL, Δa, and Δb varied between the groups. Specific combinations involving positive ΔL and Δb for EGC showed relatively high specificity but limited sensitivity.

Sep 24, 2026

Uploaded by nayy☆

Linked color imaging (LCI) improves original color tones and can help detect tumorous lesions during esophagogastroduodenoscopy, but may also amplify color changes in regions suspected of cancer without being malignant. A retrospective image analysis compared early gastric cancer (EGC) and cancer-suspected non-cancerous mucosa (CSM) using LCI. Fifteen endoscopists labeled images, while CIE-Lab measurements quantified intra-lesion versus surrounding color differences (ΔL, Δa, Δb) to identify distinguishing color characteristics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Accepted Manuscript online: 2022-11-29 Article published online: 2023-01-19 Original article Differences in color between early gastric cancer and cancer-suspected non-cancerous mucosa on linked color imaging Authors Hiromitsu Kanzaki1, Yoshiro Kawahara2, Takuya Satomi 1, Shotaro Okanoue1, Kenta Hamada2, Yoshiyasu Kono3, Masaya Iwamuro1, Seiji Kawano1, Hiroyuki Okada1,3 Institutions 1 Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan 2 Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 3 Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan submitted 20.3.2022 accepted after revision 13.10.2022 published online 30.11.2022 Bibliography Endosc Int Open 2023; 11: E90–E96 DOI 10.1055/a-1989-6643 ISSN 2364-3722 © 2022. The Author(s) . This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ([https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/)) Georg Thieme Verlag KG, Rüdigerstraße 14, 70469 Stuttgart, Germany Corresponding author Hiromitsu Kanzaki, Department of Gastroenterology and Hepatology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan Fax: +086-225-5991 [kanzaki@qc4.so-net. ne.jp](kanzaki@qc4.so-net. ne.jp) ABSTRACT Background and study aims Linked color imaging (LCI) can enhance the original color of each area and may useful to detect tumorous lesions during esophagogastroduodenoscopy. However, LCI may also enhance cancer-suspected non-cancerous regional color change. We conducted a retrospective image analysis to investigate the color characteristics of early gastric cancer (EGC) and cancer-suspected non-cancerous mucosa (CSM) in LCI. Methods LCI images of both EGC and CSM were retrospectively collected from the database of the institution. Fifteen endoscopists individually judged each image as EGC or CSM. The color difference between the inside and outside of the lesions was measured by CIE-Lab analysis in both groups and compared. Results A total of 245 LCI images of EGC (169) and CSM (76) were extracted and randomly lined for image collection. The test by the endoscopists showed accuracy, sensitivity, and specificity of 64.0%, 63.7%, and 64.0%, respectively. Although the color difference between EGC and CSM was almost the same (12.5 vs. 12.9, not significant), each parameter of ΔL (bright: –0.3 vs.–2.7, P <0.001), Δa (Reddish: 7.2 vs. 9.6, P =0.004), and Δb (Yellowish: 6.4 vs. 3.8, P <0.001) was significantly different in the groups. The color feature of both positive ΔL and Δb to EGC showed accuracy, sensitivity, and specificity of 54.7%, 39.6%, 88.2%, respectively. Conclusions The total color difference was almost the same between EGC and CSM; however, their color tones were different on linked color imaging. Although the color characteristics of EGC had high specificity, they also had low sensitivity. Supplementary material is available under [https://doi.org/10.1055/a-1989-6643](https://doi.org/10.1055/a-1989-6643) Introduction Gastric cancer is the fifth most common cancer among cancerrelated deaths [1] . Early detection and treatment are essential for preventing death from gastric cancer. Especially when mu- cosal cancer is detected, cure may be possible with cured by endoscopic treatment, which is minimally invasive and achieves organ preservation [2] . Because patients with early gastric cancer (EGC) are generally asymptomatic, surveillance esophago- E90 Kanza

FAQs

What is the study purpose regarding linked color imaging (LCI)?

To investigate how LCI color characteristics differ between early gastric cancer (EGC) and cancer-suspected non-cancerous mucosa (CSM).

How were images and diagnoses evaluated in the retrospective analysis?

LCI images for EGC and CSM were collected from the institutional database, and 15 endoscopists individually judged each image. Color differences were quantified using CIE-Lab analysis for inside versus outside lesion regions.

What did the results show about color differences between EGC and CSM?

The total color difference was almost the same, but color tones differed significantly: ΔL, Δa, and Δb varied between the groups. Specific combinations involving positive ΔL and Δb for EGC showed relatively high specificity but limited sensitivity.

Sep 24, 2026

Uploaded by nayy☆