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. 2021 Oct 23;11(11):1971.
doi: 10.3390/diagnostics11111971.

Texture and Color Enhancement Imaging Increases Color Changes and Improves Visibility for Squamous Cell Carcinoma Suspicious Lesions in the Pharynx and Esophagus

Akira Dobashi  1 , Shingo Ono  1 , Hiroto Furuhashi  1 , Toshiki Futakuchi  1 , Naoto Tamai  1 , Takashi Yamauchi  2 , Machi Suka  2 , Kazuki Sumiyama  1
Affiliations

Texture and Color Enhancement Imaging Increases Color Changes and Improves Visibility for Squamous Cell Carcinoma Suspicious Lesions in the Pharynx and Esophagus

Akira Dobashi et al. Diagnostics (Basel). .

Abstract

Texture and color enhancement imaging (TXI) has been developed as an image-enhanced endoscopy technology. TXI mode2 enhances texture and brightness, and TXI mode1 also enhances color. This study aims to assess the color differences in squamous cell carcinoma (SCC) suspicious lesions in the pharynx and esophagus using white light imaging (WLI), TXI mode1, TXI mode2, and narrow-band imaging (NBI). A total of 59 SCC suspicious lesions from 30 patients were analyzed. The color differences (ΔE) between the lesion and the surrounding mucosa were calculated for each modality. The color value was assessed using the Commission Internationale d'Eclairage L*a*b* color space. The visibility of the lesion in each modality was evaluated and compared to that in the WLI by six endoscopists. The mean ΔE values in the WLI, TXI mode1, TXI mode2, and NBI were 11.6; 18.6; 14.3; and 17.2, respectively, and the ΔE values of TXI mode1, TXI mode2, and NBI were significantly higher than those of the WLI (p < 0.001). No lesions had worse visibility, and 62.5% (37/59) had improved visibility, as assessed by more than half of the endoscopists in TXI mode1. TXI mode1 can enhance color changes and improve the visibility of SCC suspicious lesions in the pharynx and esophagus, compared to WLI.

Keywords: color difference; image enhanced endoscopy; pharyngeal cancer; squamous cell carcinoma; superficial esophageal cancer; texture and color enhancement imaging.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The algorithm of texture and color enhancement imaging (TXI).
Figure 2
Figure 2
A demonstrative case of superficial esophageal cancer. The lesion was observed by (A) WLI, (B) TXI mode1, (C) TXI mode 2, and (D) NBI. The histology obtained from the endoscopic submucosal dissection revealed squamous cell carcinoma invading the lamina propria mucosa.
Figure 3
Figure 3
Color analysis was conducted using computer software.
Figure 4
Figure 4
The result of the color difference analysis. * means p < 0.001.
See this image and copyright information in PMC

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