Evaluation And Validation Of Fuji Intelligent Color Enhancement In Superficial-Type Early Gastric Cancer

Introduction: Fuji Intelligent Color Enhancement (FICE) (Fujinon, Saitama, Japan) spectral estimation technology allows selection of spectral reflectance of a dedicated wavelength and is based on arithmetical processing by a spectral estimation matrix processing circuit of ordinary images taken from a video endoscope. The aim of this study was to investigate the usefulness of FICE in the assessment of superficial-type early gastric cancer. Methods: During the period September 2005 through December 2006, a total of 100 patients with superficial-type early gastric cancer who underwent endoscopic or surgical resection at Hiroshima University Hospital were analyzed. The instruments used in this study were a video endoscope system (VP-4400 and EG-590WR/ZW: Fujinon). The FICE process was performed at the following wavelengths: R, 530 nm; G, 455 nm; B, 455 nm. After the white-light endoscopic examination, we performed FICE endoscopic examination of a similar visual field. We scored the demarcation between cancer and normal mucosa for white-light and FICE observation, both without magnification, as follows: 1, demarcation between cancer and normal mucosa is unclear; 2, between 1 and 3; and 3, demarcation between cancer and normal mucosa is clear. Results: Observation of gastric cancer by FICE was improved from that of white-light endoscopy in 46 (46%) cases, was unchanged in 54 (54%) cases, and there was no decrement cases (0%). According to color of cancer, FICE improved observation from that of white-light endoscopy in 40% of whitish cases, 33.3% of same color cases, and 54.4% of reddish cases (Table 1). According to histologic type, FICE improved observation from that of white-light endoscopy in 48.7% of differentiated and 36.4% of undifferentiated cases (Table 2). Conclusion: FICE delineates superficial gastric cancer more easily than does white-light endoscopy and facilitates detection of changes in superficial type-gastric cancer. Table 1Change of endoscopic image with use of the FICE according to color of cancer Improvement Unchanged Decrement Whitish 4 (40%) 6 (60%) 0 (0%) Same 11 (33.3%) 22 (66.7%) 0 (0%) Reddish 31 (54.4%) 26 (45.6%) 0 (0%) Open table in a new tab Table 2Change of endoscopic image with use of the FICE according to histologic type Improvement Unchanged Decrement Differentiated 38 (48.7%) 40 (51.3%) 0 (0%) Undifferentiated 8 (36.4%) 22 (63.6%) 0 (0%) Open table in a new tab