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Texture and color enhancement imaging for detecting colorectal adenomas:Good,but not good enough

2022-08-26YingWangChenYuSunLoweScottDanDanWuXiaChen

TO THE EDlTOR

With great curiosities,we examined the article “Texture and color enhancement imaging in magnifying endoscopic evaluation of colorectal adenomas” recently published by Toyoshima

[1].In this study,a total of sixty-one consecutive adenomas with completed white light imaging (WLI),texture and color enhancement imaging (TXI),narrow band imaging (NBI),and chromoendoscopy (CE) were investigated.In the present study,the visibility score for tumor margin of TXI was significantly higher than that of WLI,but lower than that of NBI.Additionally,TXI had a higher visibility score for the vessel as well as surface pattern of the JNET classification than WLI and CE,but a lower visibility score than NBI.

A KING1 was once hunting2 in a great wood,3 and he hunted the game so eagerly that none of his courtiers4 could follow him. When evening came on he stood still and looked round him, and he saw that he had quite lost himself. He sought a way out, but could find none. Then he saw an old woman with a shaking head coming towards him; but she was a witch.5

To detect colorectal polyp and gastric cancer,endoscopy with WLI is currently the gold standard.However,the accuracy of WLI for detecting early lesions in both the colorectal and gastric regions is yet to be established[2].Meanwhile,TXI was proposed as a new image enhancement technology to resolve these drawbacks by Sato[3].To avoid losing subtle tissue differences,TXI is designed to enhance the three imaging factors in WLI (texture,brightness,and color).According to recent publications,it has been suggested that TXI may likely contribute to the increased detection rate of early gastric cancer[4].Moreover,a significant synergistic value of TXI and near-focus mode was discovered during endoscopic submucosal dissection performed in saline-immersion by improving the visibility of submucosal spaces[5].In a study by Nishizawa

[6],WLI,TXI,NBI,and chromoendoscopy were performed on twentynine patients with serrated polyps.Similarly,the authors indicated that TXI provided higher degree of clarity in visualization for the detection of serrated,colorectal polyps,as well as sessile serrated lesions.

It is noteworthy that Toyoshima

[1] concluded that the effectiveness of TXI detecting adenomas is inferior to NBI under certain circumstances.Furthermore,TXI could also be combined with other optical image enhancement technology such as NBI,since TXI is implemented entirely in the chain of endoscopic image processing.Finally,it is suggested that future researches should focus on investigating the feasibility of such combination in clinical settings in order to provide patients with more accurate diagnoses.

Grannonia could keep silence no longer, and throwing off her peasant s disguise, she discovered herself to the Prince, who was nearly beside himself with joy when he recognised his fair lady- love

All authors have no conflict(s) of interest to declare in relation to this manuscript.

Wang Y and Chen X conceived and designed the study;Wang Y,Sun CY,Lowe S,Wu DD,and Chen X participated in drafting and critical revision of the manuscript;all authors approved the final version of the manuscript.

Ying Wang 0000-0002-8983-1307;Chen-Yu Sun 0000-0003-3812-3164;Lowe Scott 0000-0002-3325-6438;Dan-Dan Wu 0000-0003-4171-9751;Xia Chen 0000-0003-1479-9802.

I walked over to the pickle jar, dug down into my pocket, and pulled out a fistful of coins. With a gamut20 of emotions choking me, I dropped the coins into the jar. I looked up and saw that Dad, carrying Jessica, had slipped quietly into the room. Our eyes locked, and I knew he was feeling the same emotions I felt. Neither one of us could speak.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers.It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license,which permits others to distribute,remix,adapt,build upon this work non-commercially,and license their derivative works on different terms,provided the original work is properly cited and the use is noncommercial.See: https://creativecommons.org/Licenses/by-nc/4.0/

China

Then he went and stood before her, and said, Ah, wife, and now you are King. Yes, said the woman, now I am King. So he stood and looked at her, and when he had looked at her thus for some time, he said, And now that you are King, let all else be, now we will wish for nothing more. Nay17, husband, said the woman, quite anxiously, I find time pass very heavily, I can bear it no longer; go to the Flounder -- I am King, but I must be Emperor, too. Alas, wife, why do you wish to be Emperor? Husband, said she, go to the Flounder. I will be Emperor. Alas, wife, said the man, he cannot make you Emperor; I may not say that to the fish. There is only one Emperor in the land. An Emperor the Flounder cannot make you! I assure you he cannot.

Liu JH

A

: Liu JH

1 Toyoshima O,Nishizawa T,Yoshida S,Yamada T,Odawara N,Matsuno T,Obata M,Kurokawa K,Uekura C,Fujishiro M.Texture and color enhancement imaging in magnifying endoscopic evaluation of colorectal adenomas.

2022;14: 96-105 [PMID: 35316981 DOI: 10.4253/wjge.v14.i2.96]

2 Choi KS,Jun JK,Park EC,Park S,Jung KW,Han MA,Choi IJ,Lee HY.Performance of different gastric cancer screening methods in Korea: a population-based study.

2012;7: e50041 [PMID: 23209638 DOI:10.1371/journal.pone.0050041]

3 Sato T.TXI: Texture and Color Enhancement Imaging for Endoscopic Image Enhancement.

2021;2021:5518948 [PMID: 33880168 DOI: 10.1155/2021/5518948]

4 Waki K,Kanesaka T,Michida T,Ishihara R,Tanaka Y.Improved visibility of early gastric cancer by using a combination of chromoendoscopy and texture and color enhancement imaging.

2022;95: 800-801 [PMID: 34971670 DOI: 10.1016/j.gie.2021.12.016]

5 Lemmers A,Bucalau AM,Verset L,Devière J.Pristine submucosal visibility using Texture and Color Enhancement Imaging during saline-immersion rectal endoscopic submucosal dissection.

2022;54: E310-E311 [PMID:34243201 DOI: 10.1055/a-1524-1298]

6 Nishizawa T,Toyoshima O,Yoshida S,Uekura C,Kurokawa K,Munkhjargal M,Obata M,Yamada T,Fujishiro M,Ebinuma H,Suzuki H.TXI (Texture and Color Enhancement Imaging) for Serrated Colorectal Lesions.

2021;11[PMID: 35011860 DOI: 10.3390/jcm11010119]