Endoscopy 2005; 37(5): 479-486
DOI: 10.1055/s-2005-861285
Innovation Forum
© Georg Thieme Verlag KG Stuttgart · New York

Techniques Using the Hemoglobin Index of the Gastric Mucosa

K.  Yao1 , M.  Kato2 , J.  Fujisaki3
  • 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
  • 2Department of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
  • 3Department of Endoscopy, Cancer Institute Hospital, Tokyo, Japan
Further Information

Publication History

Publication Date:
20 April 2005 (online)

Objectives

Color changes seen at endoscopy are important for gastrointestinal endoscopic diagnosis. Quantification of the color information is useful for a scientific assessment of endoscopic color images. Since hemoglobin is the predominant pigment in the gastrointestinal mucosa, measurement of the hemoglobin content is a reasonable method for quantifying the color in gastrointestinal endoscopic images. Recently, Tsuji et al. have developed a technique for measuring mucosal hemoglobin content using electronic endoscopic imaging data [1]. The measure is called the “index of hemoglobin” (IHb). In this article, we describe the clinical applications and the usefulness of the technique. Currently, the technique is being used for two main purposes: image analysis and image processing, as shown in Table [1].

Table 1 Image analysis and image processing using the index of hemoglobin (IHb) Image analysis: quantification of color differences seen at endoscopy a) Measurement of the mucosal hemoglobin content by calculation of the IHbb) Two-dimensional display of the distribution of hemoglobin, using an IHb color chart Image processing: adaptive IHb color-enhancement a) Ordinary endoscopic image: enhancement of the difference in color between the lesion and the background mucosa, by increasing the difference in the degree of redness and by clarifying the difference in the texture of the rednessb) Magnified endoscopic image: clear visualization of mucosal microvascular architecturec) Combination of ordinary and magnified endoscopy

References

  • 1 Tsuji S, Sato N, Kawano S, Kamada T. Functional imaging for the analysis of the mucosal blood hemoglobin distribution using electronic endoscopy.  Gastrointest Endosc. 1988;  34 332-336
  • 2 Barlow D E. Flexible endoscope technology: the video image endoscope. In: Sivak MV, ed Gastroenterologic Endoscopy. 2nd edn. Philadelphia; WB Saunders 2000: 272-282
  • 3 Nakamura K. In: Yao K, ed Clinical application of the adaptive color enhancement technique using the index of hemoglobin in gastrointestinal endoscopy. Tokyo; Olympus Optical Co 2003: 13-14
  • 4 Yao K, Yao T, Matsui T, Iwashita A, Oishi T. Hemoglobin content in intramucosal gastric carcinoma as a marker of histologic differentiation: a clinical application of quantitative electronic endoscopy.  Gastrointest Endosc. 2000;  52 241-245
  • 5 Ida K, Kuroda M, Tsuboi H. et al . Diagnosis of Helicobacter pylori infection by combined endoscopic methods [in Japanese, with English abstract].  Clin Gastroenterol. 2001;  16 1539-1546
  • 6 Tsuji S, Kawano S, Hayashi N. et al . Analysis of mucosal blood hemoglobin distribution in gastric ulcers by computed color display on electronic endoscopy.  Endoscopy. 1991;  23 321-324
  • 7 Kuroda M, Ida K, Tsuboi H. et al . Application of hemoglobin index in diagnosis of Helicobacter pylori eradication [in Japanese, with English abstract].  Clin Gastroenterol. 2001;  16 1533-1538
  • 8 Yao K, Iwashita A, Yao T. et al . Quantitative method to characterize electronic endoscopic color images of early gastric carcinomas, using index of hemoglobin [in Japanese, with English abstract].  Gastroenterol Endosc. 1997;  39 2253-2263
  • 9 Yao K, Tajiri H, Fujisaki J. et al . A new image-processing technique utilizing adaptive index of hemoglobin (IHb) color enhancement: effectiveness for determining the precise horizontal extent of intramucosal gastric cancer.  Gastrointest Endosc. 2003;  57 AB172
  • 10 Yao K, Oishi T. Microgastroscopic findings of mucosal microvascular architecture as visualized by magnifying endoscopy.  Dig Endosc. 2001;  13 S27-S33
  • 11 Kato M, Nakagawa S, Shimizu Y. et al . The efficacy of magnifying endoscopy with adaptive IHb enhancement for diagnosis of H. pylori induced gastritis.  Dig Endosc. 2002;  14 S72-S75
  • 12 Nakagawa S, Kato M, Shimizu Y. et al . Relationship between histopathologic gastritis and mucosal microvascularity: observations with magnifying endoscopy.  Gastrointest Endosc. 2003;  58 71-75
  • 13 Yao K, Oishi T, Matui T. et al . Novel magnified endoscopic findings of microvascular architecture in intramucosal gastric cancer.  Gastrointest Endosc. 2002;  56 279-284
  • 14 Yao K. Gastric microvascular architecture as visualized by magnifying endoscopy: body and antrum without pathologic change demonstrate two different patterns of microvascular architecture.  Gastrointest Endosc. 2004;  59 596-597
  • 15 Yao K, Kikuchi Y, Tanabe H. et al . Novel zoom-ednoscopy technique for visualizing the microvascular architecture of early gastric cancer enables the precise margin of the cancer to be determined thereby allowing successful resection by the endoscopic submucosal dissection method.  Endoscopy. 2004;  36 A6
  • 16 Yao K, Iwashita A, Matsui T. et al . The magnified endoscopic findings of an irregular microvascular pattern is a very useful marker for differentiating between gastritis and gastric cancer: a prospective study.  Gastrointest Endosc. 2004;  59 AB 169
  • 17 Yao K, Yao T, Iwashita A. Determining the horizontal extent of early gastric carcinoma: two modern techniques based on differences in the mucosal microvascular architecture and density between carcinoma and non-carcinomatous mucosa.  Dig Endosc. 2002;  14 S83-S87

K. Yao, M. D.

Department of Gastroenterology · Fukuoka University Chikushi Hospital

377-1 Ooaza Zokumyoin · Chikushino-city · Fukuoka, 818-8502 · Japan

Fax: +81-92-9292630

Email: yao@fukuoka-u.ac.jp

    >