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The primary goal of upper gastrointestinal endoscopy is the detection of early gastric cancers, although diagnosing small gastric cancers remains dif cult. Narrow-band imaging with magnifying endoscopy (NBI-ME) is a recently developed advanced endoscopic imaging technology recommended for the accurate diagnosis of gastric cancer ; however, reports of NBI-ME image analysis are still scarce. This study aimed to accurately diagnose early gastric cancers based on NBI-ME findings. We compared NBI-ME image differences between small early gastric cancers and gastric erosions using computerized image analysis. We retrospectively examined 94 lesions of early gastric cancers that were treated by endoscopic submucosal dissection (ESD) from January 2011 to March 2014 in our institution and 65 lesions of erosion diagnosed by biopsy as controls. We used “ProStudyR <Olympus>” as the image analysis software and compared the differences. The microvascular pattern of early gastric cancers was characterized by a larger vascular area, a more complicated depiction region, more vascular endpoints and points of intersection, and greater length and size, compared to gastric erosions. We found no differences in vascular structure between the cancers and erosions by normal endoscopy. This nding con rms the superiority of image analysis in the diagnosis of early gastric cancer. NBI-ME image analysis is a promising approach for accurate and simple diagnosis of early gastric cancers.

Image Analysis of Magnifying Endoscopy for Differentiation between Early Gastric Cancers and Gastric Erosions