Semi-Supervised Bladder Tissue Classification in Multi-Domain Endoscopic Images.

Objective The purpose of this work was to compare the efficacy of narrow band imaging-assisted transurethral resection of bladder tumour (TURB)with conventional white light imaging-assisted TURB in primary non-muscle-invasive bladder cancer. Methods Several databases were searched, including Cochrance Libarary, PubMed, Embase, Wanfang, VIP, CNKI and CBM. The endpoints were biochemical failure in 3 months , 1 year and 2 years . We performed a meta-analysis of the published data. The results are expressed as risk ratio (RR), with the corresponding 95% confidence interval (CI). Results The final analysis included seven trials comprising 1889 patients. Biochemical failure in 3months(RR0.73, 95%CI 0.55-0.96; P=0.02), 1 year(RR 0.69, 95%CI 0.58-0.80; P<0.01) and 2 years (RR 0.58, 95%CI 0.41-0.82; P=0.002)were fewer in patients who received narrow band imaging-assisted TURB . The recurrence rates of 3 months, 1 year and 2 years were 14.44%, 29.35% and 30% in white light imaging group.The recurrence rates of 3 months, 1 year and 2 years were 3.61%, 9.35% and 12.59% lower in narrow band imaging group compared with white light imaging group. Conclusions Narrow band imaging-assisted TURB was superior to conventional white light imaging-assisted TURB in primary non-muscle-invasive bladder cancer in 2 years. Key words: Bladder neoplasms; Meta-analysis; Narrow band imaging; White light imaging

This study aimed to compare the diagnostic effectiveness of narrow band imaging and autofluorescence imaging for malignant laryngopharyngeal tumours. Between May 2010 and October 2010, 50 consecutive patients with suspected laryngopharyngeal tumour underwent endoscopic laryngopharynx examination. The morphological characteristics of laryngopharyngeal lesions were analysed using high performance endoscopic systems equipped with narrow band imaging and autofluorescence imaging modes. The diagnostic effectiveness of white light image, narrow band imaging and autofluorescence imaging endoscopy for benign and malignant laryngopharyngeal lesions was evaluated. Under narrow band imaging endoscopy, the superficial microvessels of squamous cell carcinomas appeared as dark brown spots or twisted cords. Under autofluorescence imaging endoscopy, malignant lesions appeared as bright purple. The sensitivity of malignant lesion diagnosis was not significantly different between narrow band imaging and autofluorescence imaging modes, but was better than for white light image endoscopy (χ2 = 12.676, p = 0.002). The diagnostic specificity was significantly better in narrow band imaging mode than in both autofluorescence imaging and white light imaging mode (χ2 = 8.333, p = 0.016). Narrow band imaging endoscopy is the best option for the diagnosis and differential diagnosis of laryngopharyngeal tumours.

To compare the real-time diagnostic accuracy of conventional white-light imaging (WLI) endoscopy with that of narrow-band imaging (NBI) endoscopy in patients at high risk for nasopharyngeal carcinoma (NPC). Prospective study. A university tertiary care center. From July 28 through October 27, 2009, a total of 211 consecutive patients at high risk for NPC were enrolled. A high-performance endoscopic system equipped with WLI and NBI modes was used for a detailed examination of the nasopharynx during the same endoscopy. Diagnostic efficacies of WLI and NBI were compared with pathologic findings. Lesions were classified according to the detailed morphologic epithelial microvessel observations during NBI. A total of 285 lesions were detected, including 66 cancerous lesions. The sensitivity and negative predictive values of NBI in NPC screening were significantly higher than those of WLI (93.9% vs 71.2%, P=.001; and 98.1% vs 91.7%, P=.003; respectively); specificity and positive predictive value were not significantly different. During NBI, the presence of superficial, distorted, irregularly shaped microvessels indicated malignant lesions; 53 of 55 lesions (96.4%) with type IV intrapapillary capillary loops were confirmed on histologic testing as malignant. The false-negative and false-positive rates for NBI were 4.5% and 3.6%, respectively. Narrow-band imaging endoscopy is a promising tool to differentiate nonmalignant from malignant nasopharyngeal lesions on the basis of the morphologic findings of mucosal capillary vessels in vivo. In addition, NBI may increase the diagnostic value of endoscopy in populations at high risk for NPC.

1278 NARROW BAND IMAGING DIGITAL FLEXIBLE URETEROSCOPY IN DETECTION OF THE UPPER URINARY TRACT TRANSITIONAL CELL CARCINOMA: INITIAL EXPERIENCE

Narrow Band Imaging Cystoscopy and Bipolar Plasma Vaporization for Large Nonmuscle-invasive Bladder Tumors—Results of a Prospective, Randomized Comparison to the Standard Approach

Narrow Band Imaging in Gynecology

What's known on the subject? and What does the study add? In recent years, more attention has focused on the role of narrow band imaging (NBI) in bladder cancer detection and NBI technology has spread rapidly. It is an important method for diagnosing new or recurrent bladder cancer. But its diagnostic accuracy is still uncertain. This paper summarizes the diagnostic accuracy of NBI in bladder cancer and compares NBI with white light imaging. The results show that NBI cystoscopy significantly improves the detection accuracy in bladder cancer, compared with white light imaging. However, some limitations still exist. Multicentre randomized studies are recommended to determine whether the visual advantages of NBI can translate into real therapeutic benefit for individual patients. • To assess the test performance and clinical effectiveness of narrow band imaging (NBI) cystoscopy compared with white light imaging (WLI) cystoscopy in people suspected of new or recurrent bladder cancer. • Literature on NBI cystoscopy in the diagnosis of bladder cancer was searched in PubMed, EMBASE, Cochrane Library, MEDLINE and CNKI, with hand searching of relevant congress abstracts and journals. • The literature was selected according to inclusion and exclusion criteria. The Meta-DiSc1.4 software was used to review management and analysis. • Eight studies including 1022 patients assessed test performance. • On a per-person analysis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI and WLI were respectively 0.943 (95% CI 0.914-0.964) and 0.848 (95% CI 0.803-0.885), 0.847 (95% CI 0.812-0.878) and 0.870 (95% CI 0.831-0.903), 7.038 (95% CI 3.357-14.754) and 6.938 (95% CI 2.052-23.465), 0.054 (95% CI 0.012-0.237) and 0.181 (95% CI 0.091-0.361), and 185.32 (95% CI 45.714-751.26) and 42.931 (95% CI 8.088-227.88). • The area under the curve and Q* of NBI and WLI were respectively 0.9781 and 0.8944, and 0.9337 and 0.8253. • For the characterization of carcinoma in situ, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI were 0.927 (95% CI 0.878-0.960), 0.768 (95% CI 0.730-0.802), 4.545 (95% CI 2.820-7.325), 0.125 (95% CI 0.051-0.304) and 48.884 (95% CI 15.642-152.77) on a per-person analysis. • The area under the curve and Q* were 0.9391 and 0.8763. • NBI is an effective method for the identification of abnormal lesions including carcinoma in situ and can provide higher diagnostic precision of bladder cancer than WLI.

Previous studies have yielded conflicting results on the colonic polyp detection rate with narrow-band imaging (NBI) compared with white-light imaging (WLI). We compared the mean number of colonic polyps detected per patient for NBI versus WLI using a next-generation NBI system (EVIS LUCERA ELITE; Olympus Medical Systems) used with standard-definition (SD) colonoscopy and wide-angle (WA) colonoscopy. this study is a 2 × 2 factorial, prospective, multicenter randomized controlled trial. this study was conducted at five academic centers in Japan. patients were allocated to one of four groups: (1) WLI with SD colonoscopy (H260AZI), (2) NBI with SD colonoscopy (H260AZI), (3) WLI with WA colonoscopy (CF-HQ290), and (4) NBI with WA colonoscopy (CF-HQ290). the mean numbers of polyps detected per patient were compared between the four groups: WLI with/without WA colonoscopy and NBI with/without WA colonoscopy. Of the 454 patients recruited, 431 patients were enrolled. The total numbers of polyps detected by WLI with SD, NBI with SD, WLI with WA, and NBI with WA were 164, 176, 188, and 241, respectively. The mean number of polyps detected per patient was significantly higher in the NBI group than in the WLI group (2.01 vs 1.56; P = 0.032). The rate was not higher in the WA group than in the SD group (1.97 vs 1.61; P = 0.089). Although WA colonoscopy did not improve the polyp detection, next-generation NBI colonoscopy represents a significant improvement in the detection of colonic polyps.

A Prospective Study for Differential Diagnosis of Gastric Small Depressive Lesions By Narrow Band Imaging (NBI) Combined with Magnifying Endoscopy

To characterize the appearance of normal and malignant upper urinary tract lesion appearance under narrow-band imaging (NBI) using the new URF-V digital flexible ureteroscope (DFU), and to determine if NBI, when used in conjunction with white light (WL), could improve detection of malignancy. NBI and WL were performed in 27 patients at our university teaching hospital, 14 with known cases of upper urinary tract transitional-cell carcinoma (UUT-TCC) as follow-up (group A), and 13 patients with first-suspicion of cancer (group B). Full renal collecting system examination was performed first under WL and then under NBI by a single urologist. Biopsies were taken from all detected lesions using the biopsy forceps and sent for examination by a pathologist who was blinded to the gross description of the lesion. Pathology interpretations were then compared with the corresponding WL and NBI images. Holmium laser vaporization was performed for all apparent lesions. Subjectively, NBI significantly improved the endoscopic visualization of the tumors, providing a detailed description of their limits and vascular architecture. Objectively, five additional tumors (14.2%) in four patients, as well the extended limits of three tumors (8.5%) in three patients were detected by NBI when findings by WL imaging were considered normal. This is one of the first reports regarding NBI for UUT-TCC. From this study, we recommend this technology as a valuable diagnostic method, because it considerably improves tumor detection rate by 22.7% compared with WL.

BACKGROUNDOlympus Corporation has developed texture and color enhancement imaging (TXI) as a novel image-enhancing endoscopic technique.AIMTo investigate the effectiveness of TXI in identifying colorectal adenomas using magnifying observation.METHODSColorectal adenomas were observed by magnified endoscopy using white light imaging (WLI), TXI, narrow band imaging (NBI), and chromoendoscopy (CE). This study adopted mode 1 of TXI. Adenomas were confirmed by histological examination. TXI visibility was compared with the visibility of WLI, NBI, and CE for tumor margin, and vessel and surface patterns of the Japan NBI expert team (JNET) classification. Three expert endoscopists and three non-expert endoscopists evaluated the visibility scores, which were classified as 1, 2, 3, and 4.RESULTSSixty-one consecutive adenomas were evaluated. The visibility score for tumor margin of TXI (3.47 ± 0.79) was significantly higher than that of WLI (2.86 ± 1.02, P < 0.001), but lower than that of NBI (3.76 ± 0.52, P < 0.001), regardless of the endoscopist’s expertise. TXI (3.05 ± 0.79) had a higher visibility score for the vessel pattern of JNET classification than WLI (2.17 ± 0.90, P < 0.001) and CE (2.47 ± 0.87, P < 0.001), but lower visibility score than NBI (3.79 ± 0.47, P < 0.001), regardless of the experience of endoscopists. For the visibility score for the surface pattern of JNET classification, TXI (2.89 ± 0.85) was superior to WLI (1.95 ± 0.79, P < 0.01) and CE (2.75 ± 0.90, P = 0.002), but inferior to NBI (3.67 ± 0.55, P < 0.001).CONCLUSIONTXI provided higher visibility than WLI, lower than NBI, and comparable to or higher than CE in the magnified observation of colorectal adenomas.

Optical diagnosis of superficial nonampullary duodenal epithelial tumors using white-light imaging (WLI) and/or narrow-band imaging with magnifying endoscopy (NBI-ME) is used to guide the treatment strategy and avoid biopsy-induced fibrosis. However, the effectiveness of this approach has not been elucidated. We conducted a systematic review and meta-analysis aiming to investigate the diagnostic yield between Vienna classification category 3 (VCL C3) and categories 4 or 5 (VCL C4/C5) using biopsy, WLI, NBI-ME, and WLI + NBI-ME. A literature search identified studies on the diagnosis of superficial nonampullary duodenal epithelial tumors using biopsy, WLI, or NBI-ME. A bivariate random-effects model was utilized to analyze the summary estimates of sensitivity and specificity, as well as the area under the summary receiver operating characteristic curves for diagnosing VCL C4/C5. Ultimately, 13 studies were included in the meta-analysis. For the diagnosis of VCL C4/C5, summary estimates of sensitivity, specificity, and area under the curve were for biopsy 47% (95% confidence interval: 37-58), 86% (79-91), and 0.745; for WLI 80% (65-89), 80% (70-87), and 0.859; for NBI-ME were 72% (61-81), 76% (68-85), and 0.811; and for WLI + NBI-ME 88% (67-96), 87% (51-98), and 0.929, respectively. WLI, NBI-ME, and WLI + NBI-ME showed high values for sensitivity and area under the curve. Biopsies can be replaced by WLI, NBI-ME, and WLI + NBI-ME for the preoperative diagnosis of superficial nonampullary duodenal epithelial tumors. However, further accumulation of research findings is needed.

BackgroundTexture and color enhancement imaging (TXI), a new type of image-enhanced endoscopy, may improve the detection of gastrointestinal lesions. Barrett’s esophagus (BE) requires an accurate diagnosis since it may undergo neoplastic transformation. We aimed to evaluate the usefulness of TXI compared with white light imaging (WLI) in BE.Material/MethodsIn this prospective study at a single hospital from February 2021 to February 2022, we enrolled 52 consecutive patients with BE. Endoscopic images of BE using WLI, TXI mode 1 (TXI-1), TXI mode 2 (TXI-2), and narrow-band imaging (NBI) were compared by 10 endoscopists (5 experts and 5 trainees). Endoscopists scored visibility for the images as follows: 5 (improved), 4 (somewhat improved), 3 (equivalent), 2 (somewhat decreased), and 1 (decreased). Total visibility scores for all 10 endoscopists, and subgroups composed of the 5 expert endoscopists and the 5 trainee endoscopists, were evaluated. Main-group (10 endoscopists) scores of ≥40, 21–39, and ≤20, and subgroup (5 endoscopists) scores of ≥20, 11–19, and ≤10, were considered “improved”, “equivalent”, and “decreased”, respectively. Inter-rater reliability (intra-class correlation coefficient [ICC]) was calculated and images were objectively assessed based on L*a*b* color values and color differences (ΔE*).ResultsAll 52 cases were diagnosed as short-segment BE (SSBE). TXI-1/TXI-2 improved visibility compared with WLI was: 78.8%/32.7% for all endoscopists; 82.7%/40.4% for trainees; and 76.9%/34.6% for experts. NBI did not improve visibility. The ICC for TXI-1 and TXI-2 compared with WLI was “excellent” for all endoscopists. The ΔE* between esophageal and Barrett’s mucosae, and between Barrett’s and gastric mucosae, was higher for TXI-1 than for WLI (P<0.01, P<0.05, respectively).ConclusionsTXI, especially TXI-1, improves the endoscopic diagnosis of SSBE compared with WLI, regardless of the endoscopist’s skill.

To cope with the growing prevalence of colorectal cancer (CRC), screening\nprograms for polyp detection and removal have proven their usefulness.\nColonoscopy is considered the best-performing procedure for CRC screening. To\nease the examination, deep learning based methods for automatic polyp detection\nhave been developed for conventional white-light imaging (WLI). Compared with\nWLI, narrow-band imaging (NBI) can improve polyp classification during\ncolonoscopy but requires special equipment. We propose a CycleGAN-based\nframework to convert images captured with regular WLI to synthetic NBI (SNBI)\nas a pre-processing method for improving object detection on WLI when NBI is\nunavailable. This paper first shows that better results for polyp detection can\nbe achieved on NBI compared to a relatively similar dataset of WLI. Secondly,\nexperimental results demonstrate that our proposed modality translation can\nachieve improved polyp detection on SNBI images generated from WLI compared to\nthe original WLI. This is because our WLI-to-SNBI translation model can enhance\nthe observation of polyp surface patterns in the generated SNBI images.\n

<title>Abstract</title> Purpose Although image-enhanced endoscopy (IEE) is useful, its benefit over white light imaging (WLI) for the detection of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. We evaluated whether narrow-band imaging (NBI) and texture and color enhancement imaging (TXI) could improve SNADET visibility compared to WLI under CO ₂ insufflation and underwater conditions. Methods We conducted a post-hoc analysis using a prospectively collected image database from patients with SNADET enrolled in a multicenter observational study. We used the EVIS X1 system with a GIF-H290Z or GIF-EZ1500 endoscope to compare the visibility scores for the recognition of SNADETs. We also measured the color difference (ΔE*), saturation difference (ΔC*), and lightness difference(ΔL*) between the tumor and background mucosa. Results We analyzed 50 lesions, comprising 46 intramucosal adenocarcinomas and 4 adenomas. Under CO ₂ insufflation, TXI provided a significantly higher visibility score than the WLI (2.7 ± 0.8 vs 2.5 ± 0.9, <italic>P</italic> = 0.002); however, no significant differences were observed between TXI and NBI (2.7 ± 0.8 vs 2.6 ± 0.7, <italic>P</italic> = 0.072). Underwater conditions yielded significantly higher visibility scores than CO ₂ insufflation across the three modes (WLI, 3.1 ± 0.6 vs. 2.5 ± 0.9, <italic>P</italic> &lt; 0.001; NBI, 2.9 ± 0.7 vs. 2.6 ± 0.7, <italic>P</italic> &lt; 0.001; TXI, 3.2 ± 0.5 vs. 2.7 ± 0.8, <italic>P</italic> &lt; 0.001). The ΔC* in TXI was significantly higher than that in WLI under CO ₂ insufflation (8.5 ± 6.0 vs 5.9 ± 3.9, <italic>P</italic> &lt; 0.001) and underwater condition (9.2 ± 5.6 vs 6.6 ± 3.5, <italic>P</italic> &lt; 0.001). Conclusion TXI significantly improved SNADET visibility compared to WLI under CO ₂ insufflation and underwater conditions, likely due to the increased saturation difference.