Abstract
Recognition of lesions with subtle morphological and/or color changes during white light imaging (WLI) endoscopy remains a challenge. Often the endoscopic image suffers from nonuniform illumination across the image due to curvature in the lumen and the direction of the illumination light of the endoscope. We propose an image enhancement technology to resolve the drawbacks above called texture and color enhancement imaging (TXI). TXI is designed to enhance three image factors in WLI (texture, brightness, and color) in order to clearly define subtle tissue differences. In our proposed method, retinex-based enhancement is employed in the chain of endoscopic image processing. Retinex-based enhancement is combined with color enhancement to greatly accentuate color tone differences of mucosal surfaces. We apply TXI to animal endoscopic images and evaluate the performance of TXI compared with conventional endoscopic enhancement technologies, conventionally used techniques for real-world image processing, and newly proposed techniques for surgical endoscopic image augmentation. Our experimental results show that TXI can enhance brightness selectively in dark areas of an endoscopic image and can enhance subtle tissue differences such as slight morphological or color changes while simultaneously preventing over-enhancement. These experimental results demonstrate the potential of the proposed TXI algorithm as a future clinical tool for detecting gastrointestinal lesions having difficult-to-recognize tissue differences.
Highlights
Endoscopic screening plays a significant role in early lesion detection for reducing gastrointestinal cancer-related mortality
We apply texture and color enhancement imaging (TXI) to animal endoscopic images and evaluate the performance of TXI by compared against conventional image-enhanced endoscopy (IEE) methods used in clinical practice such as structure enhancement [9] and index of hemoglobin (IHb) color enhancement [9], real-world image processing techniques such as Histogram equalization (HE), and a newly proposed technique [16] for surgical endoscopic image augmentation. e results from these animal experiments show that TXI provides a balance of improving image features important for the physician searching for abnormalities while minimizing gross changes that may negatively impact familiarity
IHb color enhancement [9] is a setting that increases color contrast based on a hemoglobin index in the image, and red color becomes more red and white color becomes whiter
Summary
Endoscopic screening plays a significant role in early lesion detection for reducing gastrointestinal cancer-related mortality. Colorectal cancer is the most common gastrointestinal cancer worldwide, and over 1.8 million new cases and 862,000 deaths were reported in 2018 [1]. Early detection of colorectal polyps during total colonoscopy is important to avoid interval cancer, and the improvement of the adenoma detection rate by 1% is associated with a 3% decrease in the rate of the interval cancer [2]. Gastric cancer is the second most common gastrointestinal cancer worldwide and early detection is useful for improving the 5-year disease-specific survival rate [3]. E current standard practice for colorectal polyp detection and gastric cancer detection is endoscopy using white light imaging (WLI); the performance of WLI for detecting early colorectal and gastric lesions is not satisfactory [4, 5]. Polyps having slight morphological change such as flat or depressed polyps and polyps that are pale in appearance or have subtle color changes are likely to be overlooked [6,7,8]
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