A video endoscopy system (LASEREO, Fujifilm Corporation, Tokyo, Japan) and high-definition upper gastrointestinal endoscope (EG-L590ZW; Fujifilm Corporation, Tokyo, Japan) were used for WLI and BLI in the BLI-ME group. The structure enhancement of the endoscopic video processor was set to A-mode level 6 or B-mode level 8 for BLI. The color mode was fixed to level C1. A video endoscope system (EVIS ELITE, LUCERA SPECTRUM system, Olympus Co, Tokyo, Japan) and high-resolution upper gastrointestinal endoscope-GIF-H260Z, Olympus Co, Tokyo Japan) were used in the NBI group. The structure enhancement function of the endoscopic video processor was set to A-mode level 8 for WLI and B-mode level 8 for NBI. The color mode was fixed to level 1 for NBI.
Eg l590zw
Manufactured by Fujifilm
Sourced in Japan
The EG-L590ZW is a lab equipment product from Fujifilm. It is designed to perform specific functions in a laboratory setting. The device's core function is to provide reliable and consistent results, but a detailed description cannot be provided while maintaining an unbiased and factual approach.
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Lab products found in correlation
Gif h260z, by Olympus (4 mentions)
Gif hq290, by Olympus (3 mentions)
Lasereo, by Fujifilm (2 mentions)
Sie p2 system, by Fujifilm (2 mentions)
Vp 4450hd, by Fujifilm (2 mentions)
Evis lucera, by Olympus (1 mentions)
Gif xq260, by Olympus (1 mentions)
Gif q260, by Olympus (1 mentions)
Gif h290, by Olympus (1 mentions)
Eg 590wr, by Fujifilm (1 mentions)
Eg 590 zw, by Fujifilm (1 mentions)
Flush knife, by Fujifilm (1 mentions)
Hq 260, by Olympus (1 mentions)
Hq 290, by Olympus (1 mentions)
Ll 4450, by Fujifilm (1 mentions)
Eg l600zw, by Fujifilm (1 mentions)
Gif h260, by Olympus (1 mentions)
Gif h290z, by Olympus (1 mentions)
Eluxeo 7000, by Fujifilm (1 mentions)
Evis lucera cv 260 clv 260, by Olympus (1 mentions)
10 protocols using eg l590zw
1
Comparative Endoscopic Imaging Techniques
2
Comparison of Upper GI Endoscopic Systems
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Two different upper GI endoscopic systems manufactured by Olympus Medical Systems Co. and Fujifilm Co. were used in this study. A high-resolution endoscope (GIF-H260Z; Olympus Medical Systems Co., Tokyo, Japan) and a video processor with NBI function (EVIS LUCERA; Olympus Medical Systems Co., Tokyo, Japan) were used for white light imaging (O-WLI) observation and narrow band imaging (NBI) observation. The structure enhancement of the endoscopic video processor was set to B-mode level 3 for O-WLI and B-mode level 8 for NBI. The color mode was fixed at level 1 for NBI.
A high-resolution endoscope (EG-L590ZW; Fujifilm Co., Tokyo, Japan) and a video processor with BLI-bright function (LASEREO; Fujifilm Co., Tokyo, Japan) were used for white light imaging (F-WLI) observation and blue laser imaging-bright (BLI-bright) observation. The structure enhancement of the endoscopic video processor was set to A-mode level 6 for BLI-bright. The color mode was fixed at level C1. The depth of field for the GIF-H260Z and EG-L590ZW endoscope was 7 to 100 mm and 6 to 100 mm, respectively. The field of view for both endoscopes was 140 degrees.
A high-resolution endoscope (EG-L590ZW; Fujifilm Co., Tokyo, Japan) and a video processor with BLI-bright function (LASEREO; Fujifilm Co., Tokyo, Japan) were used for white light imaging (F-WLI) observation and blue laser imaging-bright (BLI-bright) observation. The structure enhancement of the endoscopic video processor was set to A-mode level 6 for BLI-bright. The color mode was fixed at level C1. The depth of field for the GIF-H260Z and EG-L590ZW endoscope was 7 to 100 mm and 6 to 100 mm, respectively. The field of view for both endoscopes was 140 degrees.
3
Endoscopic PDD for Esophagogastric Lesions
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Endoscopic PDD was performed 3 h after the oral administration of 20 mg/kg 5-ALA. For the in vivo fluorescence detection of PpIX accumulation, a Sie-P1video image endoscope system (Fuji Film Medical Co., Tokyo, Japan) consisting of a VP-0001 processor, an LL-4450-P1 light source, and an XG-0002-P1 scope or a Sie-P2 system (Fuji Film Medical Co.) with a VP-7000-P2 processor, an LL-7000-P2 light source, and an EG-L590ZW esophagogastroduodenoscopy scope was used (12 (link), 13 (link)). A 410-nm laser was used for blue-light excitation of PpIX to induce red fluorescence emittance. When a fluorescence signal was visualized and confined to the tumor and not in the surrounding non-tumorous tissue, it was referred to as PDD-positive. After identifying the lesion, the stomach cavity was evaluated followed by endoscopic submucosal dissection (ESD) of the target lesion(s). Thus, endoscopic PDD was performed on the day of ESD immediately prior to performing the ESD procedure. Whereas ESD was performed for lesions with a nominal risk of lymph node metastasis, in accordance with previously described criteria (14 (link)), five patients underwent standard surgery with the removal of regional lymph nodes. All patients were shielded from strong light, such as direct sunlight, for 24 h following the 5-ALA PDD procedure to avoid potential phototoxic reactions.
4
Novel Prototype Endoscope for LPDED
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We developed a novel second-generation prototype endoscope system for LPDED, called the Sie-P2 system (FUJIFILM Co., Tokyo, Processor: VP-7000-P2, Light source: LL-7000-P2, EGD scope: EG-L590ZW). LL-7000-P2 was constructed by adjusting a LASEREO7000 to irradiate with laser light at 410 nm, more strongly (around 2-fold) than the LASEREO4450 that formed the basis of the Sie-P1 system. We believed that strong irradiation with this 410 nm laser would achieve powerful excitation light and thus strong PpIX fluorescence emission. The EG-L590ZW is a commercially available endoscope that does not have a cut filter to exclude excitation light. Adjustment of the white balance was required to achieve the preferred color inside the processor. With this prototype endoscope system, by pushing a button it is easy to switch between the WLI, BLI, and PDD modes in turn.
5
Gastrointestinal Scope Imaging Protocol
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6
Magnifying Endoscopy and Endoscopic Submucosal Dissection
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Magnifying endoscopy with blue laser imaging (BLI) (EG-L590ZW; Fujifilm, Tokyo, Japan) was used for endoscopic diagnosis and identification of the AVAs (
Fig. 1 a ). A soft black hood was attached to the tip of the scope to obtain the appropriate distance from the lesions and to focus on the surface of the lesions accurately during magnification.
ESD was performed in the Department of Endoscopic Diagnostics and Therapeutics under sedation or in the operating room under general anesthesia. After iodine staining and marking the borders of the lesion, glycerol solution (10 % glycerol 300 mL) along with indigo carmine (0.6 mL) and 0.1 % adrenaline (0.6 mL) was injected into the submucosal layer to lift the lesion from the muscularis propria. The incision of the mucosa started at the distal margin of the lesion followed by proximal extension with a flush knife (Fujifilm, Tokyo, Japan). Then, submucosal dissection was performed using the flush knife and Mucosectom (Pentax, Tokyo, Japan). The resected lesion was extended, stuck on a board, and fixed with formalin.
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Magnifying endoscopy with blue laser imaging (BLI) (EG-L590ZW; Fujifilm, Tokyo, Japan) was used for endoscopic diagnosis and identification of the AVAs (
ESD was performed in the Department of Endoscopic Diagnostics and Therapeutics under sedation or in the operating room under general anesthesia. After iodine staining and marking the borders of the lesion, glycerol solution (10 % glycerol 300 mL) along with indigo carmine (0.6 mL) and 0.1 % adrenaline (0.6 mL) was injected into the submucosal layer to lift the lesion from the muscularis propria. The incision of the mucosa started at the distal margin of the lesion followed by proximal extension with a flush knife (Fujifilm, Tokyo, Japan). Then, submucosal dissection was performed using the flush knife and Mucosectom (Pentax, Tokyo, Japan). The resected lesion was extended, stuck on a board, and fixed with formalin.
7
Endoscopic Atrophy Grading in Gastric Assessment
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We performed endoscopic examinations using endoscopes (Q-260, HQ-260, and HQ-290 and others, Olympus, Tokyo, Japan and EG-L590ZW, Fujifilm Co, Tokyo, Japan). Endoscopic atrophy was assessed according to the Kimura–Takemoto classification.(16 ) This classification system includes the following classifications: 1) close-type, when an atrophic border remains on the lesser curvature of the stomach; or 2) open-type, when the atrophic border extends along the anterior and posterior walls of the stomach and is not associated with the lesser curvature of the stomach. In this study, atrophy grade was scored as follows: absence of any atrophy, 0; C1, 1; C2, 2; C3, 3; O1, 4; O2, 5; and O3, 6, respectively.
8
Endoscopic Imaging of Early Gastric Cancer
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All examinations were carried out by 4 skilled endoscopists accredited by the Japan Gastroenterological Endoscopy Society, with EG-L590ZW and EG-L600ZW endoscopes corresponding to the LASEREO system, consisting of a VP-4450HD processor and an LL 4450 light source (FUJIFILM Co., Tokyo, Japan) (Video S1 ). Endoscopic video clips of the entire gastric mucosa were recorded for about a min using WLI, BLI-bright, and LCI after washing and removing gastric mucus (Figure 1 a,b). At this time, we paid particular attention to keeping the shooting speed as constant as possible. Next, a close-up movie of the EGCs was recorded for several seconds using WLI, BLI-bright, and LCI. At this time, we recorded a movie of the entire lesion in the front view from a short or middle distance (Figure 1 c,d,f). Then, low magnifying movies of EGC with the demarcation line at the oral or anal side of the lesion were recorded for several seconds using WLI and each IEE (Figure 1 e).
9
Retrospective Analysis of Gastric Biopsies
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We retrospectively reviewed patients undergoing esophagogastroduodenoscopy (EGD) with gastric biopsies or H. pylori breath test at Renmin Hospital of Wuhan University (RHWU) between June 2020 and July 2021. We included 1826 patients (881 H. pylori positive and 945 H. pylori negative) for the development of EADHI. Table 1 shows the patient characteristics. Exclusion criteria include (1) patients with a history of GC, peptic ulcer, gastric surgery, or submucosal tumor and (2) patients who received H. pylori eradication or administered antibiotics within a month or proton pump inhibitor within 2 weeks of H. pylori breath test.
EGD was performed using a standard endoscope (GIF-HQ290, GIF-H260; Olympus, Tokyo, Japan; EG-L590ZW; Fujifilm, Tokyo, Japan) and the images were captured during high-definition, white-light examination of the antrum, angularis (retroflex), body (forward and retroflex), and fundus (retroflex). Gastric biopsies were performed in the antrum and body at the endoscopist’s discretion.
EGD was performed using a standard endoscope (GIF-HQ290, GIF-H260; Olympus, Tokyo, Japan; EG-L590ZW; Fujifilm, Tokyo, Japan) and the images were captured during high-definition, white-light examination of the antrum, angularis (retroflex), body (forward and retroflex), and fundus (retroflex). Gastric biopsies were performed in the antrum and body at the endoscopist’s discretion.
10
Gastric Lesion Evaluation with Endoscopic Imaging
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Four datasets were used for training, validation, and testing the models, including training and validating set (Dataset 1), image test set (Dataset 2), video test set (Dataset 3), and prospective test set (Dataset 4). The detailed information of four dataset were presented in the supplementary materials.
Inclusion criteria: the lesions were viewed at WL and WM mode. Exclusion criteria: the lesions were hard to evaluate because of poor-quality views, resulting from active bleeding, thick white coats, blurs, defocus, mucus, and so on.
Two senior endoscopists were involved in labeling images, selecting and editing videos, both of whom had an experience of EGD over 5 years.
The equipment used in this study included standard gastroscopes [(EG-L590ZW; Fujifilm, Tokyo, Japan), (GIF-HQ290, GIF-H260Z, GIF-H290Z; Olympus Medical Systems, Tokyo, Japan)] and video systems [(ELUXEO 7000, LASEREO7000 and VP-4450HD; Fujifilm, Tokyo, Japan), (EVIS LUCERA CV-260/CLV-260 and EVIS LUCERA ELITE CV-290/CLV-290SL; Olympus Medical Systems, Tokyo, Japan)].
Inclusion criteria: the lesions were viewed at WL and WM mode. Exclusion criteria: the lesions were hard to evaluate because of poor-quality views, resulting from active bleeding, thick white coats, blurs, defocus, mucus, and so on.
Two senior endoscopists were involved in labeling images, selecting and editing videos, both of whom had an experience of EGD over 5 years.
The equipment used in this study included standard gastroscopes [(EG-L590ZW; Fujifilm, Tokyo, Japan), (GIF-HQ290, GIF-H260Z, GIF-H290Z; Olympus Medical Systems, Tokyo, Japan)] and video systems [(ELUXEO 7000, LASEREO7000 and VP-4450HD; Fujifilm, Tokyo, Japan), (EVIS LUCERA CV-260/CLV-260 and EVIS LUCERA ELITE CV-290/CLV-290SL; Olympus Medical Systems, Tokyo, Japan)].
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