J Korean Med Sci.  2006 Dec;21(6):1041-1047. 10.3346/jkms.2006.21.6.1041.

Analysis of Endoscopic Electronic Image of Intramucosal Gastric Carcinoma Using a Software Program for Calculating Hemoglobin Index

• Kim GH
• Kim KB
• Lim EK
• Choi SH
• Kim TO
• Heo J
• Kang DH
• Song GA
• Cho M
• Park DY

• KMID: 1713116
• DOI: http://doi.org/10.3346/jkms.2006.21.6.1041

Abstract

Hemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of the IHb-C to the IHb-N (C/N ratio). The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.

Keyword

Stomach Neoplasms; Hemoglobin Index; Software; Software Validation; Endoscopy; Image, Endoscopy

MeSH Terms

Tumor Markers, Biological/*analysis
Stomach Neoplasms/classification/*diagnosis
*Software
Sensitivity and Specificity
Reproducibility of Results
Neoplasm Proteins/analysis
Male
Image Interpretation, Computer-Assisted/*methods
Humans
Hemoglobins/*analysis
Gastroscopy/*methods
Gastric Mucosa/metabolism/*pathology
Female
Colorimetry/methods

Figure

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  Fig. 1 Examples of the area selection methods.

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  Fig. 2 Display of an example of the distribution information for each color channel in a selected area.

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  Fig. 3 Area segmentation results along with the color models and the segmentation methods.

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  Fig. 4 (A) Electronic endoscopic image of an intestinal-type gastric carcinoma in the body of the stomach. The first marking was done on the margin of the carcinoma and then the second marking was done on the surrounding non-cancerous mucosa. (B) The mean IHb was calculated from the data of the picture elements on the described area. The C/N ratio was 1.26 (IHb-C: 37.7, IHb-N: 30.0).

• 

  Fig. 5 (A) Electronic endoscopic image of a diffuse-type gastric carcinoma in the body of the stomach. The first marking was done on the margin of the carcinoma and then the second marking was done on the surrounding non-cancerous mucosa. (B) The mean IHb was calculated from the data of the picture elements on the described area. The C/N ratio was 0.84 (IHb-C: 28.3, IHb-N: 33.6).

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  Fig. 6 The C/N ratio in the diffuse-type carcinoma group and in the intestinal-type carcinoma group.

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  Fig. 7 The C/N ratio in the intestinal-type carcinoma group and in the diffuse-type carcinoma group according to the location.

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