Quantitative identification of mucosal gastric cancer under magnifying endoscopy with flexible spectral imaging color enhancement

J Gastroenterol Hepatol. 2013 May;28(5):841-7. doi: 10.1111/jgh.12149.

Abstract

Background and aim: Magnifying endoscopy with flexible spectral imaging color enhancement (FICE) is clinically useful in diagnosing gastric cancer and determining treatment options; however, there is a learning curve. Accurate FICE-based diagnosis requires training and experience. In addition, objectivity is necessary. Thus, a software program that can identify gastric cancer quantitatively was developed.

Methods: A bag-of-features framework with densely sampled scale-invariant feature transform descriptors to magnifying endoscopy images of 46 mucosal gastric cancers was applied. Computer-based findings were compared with histologic findings. The probability of gastric cancer was calculated by means of logistic regression, and sensitivity and specificity of the system were determined.

Results: The average probability was 0.78 ± 0.25 for the images of cancer and 0.31 ± 0.25 for the images of noncancer tissue, with a significant difference between the two groups. An optimal cut-off point of 0.59 was determined on the basis of the receiver operating characteristic curves. The computer-aided diagnosis system yielded a detection accuracy of 85.9% (79/92), sensitivity for a diagnosis of cancer of 84.8% (39/46), and specificity of 87.0% (40/46).

Conclusion: Further development of this system will allow for quantitative evaluation of mucosal gastric cancers on magnifying gastrointestinal endoscopy images obtained with FICE.

MeSH terms

  • Aged
  • Color*
  • Diagnosis, Computer-Assisted / methods*
  • Female
  • Gastroscopy / methods*
  • Humans
  • Image Enhancement / methods*
  • Logistic Models
  • Male
  • Predictive Value of Tests
  • Probability
  • ROC Curve
  • Sensitivity and Specificity
  • Software
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / pathology*