{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:04:35Z","timestamp":1784761475474,"version":"3.55.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["24hma922022h0001"],"award-info":[{"award-number":["24hma922022h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["25hma322042h0001"],"award-info":[{"award-number":["25hma322042h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","award":["JP24K15772"],"award-info":[{"award-number":["JP24K15772"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Generative indigo carmine chromoendoscopy (generative chromoendoscopy), produced using deep learning-based synthetic image transformation, is a novel image-enhanced endoscopic approach, whose clinical feasibility has not been validated. This proof-of-concept study evaluated whether generative chromoendoscopy improves the visibility of gastric neoplasms compared with conventional white-light imaging (WLI) and real chromoendoscopy.<\/jats:p>\n                  <jats:p>This prospective multicenter study was conducted at three Japanese institutions between January and August 2025. A deep neural network-based program converted WLI into generative chromoendoscopy images. Patients with early gastric cancer or adenoma sequentially underwent endoscopy using WLI, generative chromoendoscopy, and real chromoendoscopy. During live endoscopy, two endoscopists independently assessed lesion visibility using a 7-point Likert-type scale (\u22123 to +3). The primary end point was visibility of gastric neoplasms with generative chromoendoscopy relative to WLI, with comparison to real chromoendoscopy. Secondary end points included clinicopathologic factors associated with improved visibility.<\/jats:p>\n                  <jats:p>60 patients were included. Mean (SD) visibility scores were 0.67 (0.93) for generative chromoendoscopy and 0.51 (1.00) for real chromoendoscopy. The mean difference was 0.16 (95%CI 0.01 to 0.30). Differentiated-type histology (odds ratio [OR] 2.19, 95%CI 1.03 to 4.62), current Helicobacter pylori infection (OR 2.14, 95%CI 1.02 to 4.46), and expert endoscopist status (OR 2.14, 95%CI 1.22 to 3.76) were significantly associated with higher visibility scores using generative chromoendoscopy.<\/jats:p>\n                  <jats:p>Generative chromoendoscopy was feasible during live endoscopic procedures. It improved visibility of pre-identified gastric neoplasms compared with WLI and achieved visibility comparable to real chromoendoscopy.<\/jats:p>","DOI":"10.1055\/a-2873-4466","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:34:37Z","timestamp":1778283277000},"page":"848-855","source":"Crossref","is-referenced-by-count":0,"title":["Generative chromoendoscopy for gastric neoplasms: a multicenter prospective study"],"prefix":"10.1055","volume":"58","clinical-trial-number":[{"clinical-trial-number":"jrcts032240564","registry":"10.18810\/jrct"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-1409","authenticated-orcid":false,"given":"Sho","family":"Suzuki","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare Ichikawa Hospital, Chiba, Japan","place":["Ichikawa"],"department":["Department of Gastroenterology"]},{"name":"International University of Health and Welfare, Japan","place":["Narita"],"department":["Faculty of Medicine, Graduate School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Monno","sequence":"additional","affiliation":[{"name":"Institute of Science Tokyo, Japan","place":["Tokyo"],"department":["Department of Systems and Control Engineering, School of Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan","place":["Tokyo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0130-7170","authenticated-orcid":false,"given":"Ayaka","family":"Takasu","sequence":"additional","affiliation":[{"name":"Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan","place":["Tokyo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Hirasawa","sequence":"additional","affiliation":[{"name":"Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan","place":["Tokyo"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-3384","authenticated-orcid":false,"given":"Toshihiro","family":"Nishizawa","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare, Japan","place":["Narita"],"department":["Faculty of Medicine, Graduate School of Medicine"]},{"name":"International University of Health and Welfare Narita Hospital, Japan","place":["Narita"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Ito","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare Ichikawa Hospital, Chiba, Japan","place":["Ichikawa"],"department":["Department of Gastroenterology"]},{"name":"International University of Health and Welfare, Japan","place":["Narita"],"department":["Faculty of Medicine, Graduate School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-7958","authenticated-orcid":false,"given":"Fumiaki","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare Ichikawa Hospital, Chiba, Japan","place":["Ichikawa"],"department":["Department of Gastroenterology"]},{"name":"International University of Health and Welfare, Japan","place":["Narita"],"department":["Faculty of Medicine, Graduate School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Okutomi","sequence":"additional","affiliation":[{"name":"Institute of Science Tokyo, Japan","place":["Tokyo"],"department":["Department of Systems and Control Engineering, School of Engineering"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Tada","sequence":"additional","affiliation":[{"name":"AI Medical Service Inc., Japan","place":["Tokyo"]},{"name":"J\u2019s Clinic of Gastrointestinal Endoscopy & Proctology, Japan","place":["Saitama"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"F Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1111\/den.14063","article-title":"Endoscopic screening for gastric cancer in Japan: Current status and future perspectives","volume":"34","author":"K Mabe","year":"2022","journal-title":"Dig Endosc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1053\/j.gastro.2017.01.029","article-title":"Effectiveness of the Korean national cancer screening program in reducing gastric cancer mortality","volume":"152","author":"JK Jun","year":"2017","journal-title":"Gastroenterology"},{"key":"ref4","first-page":"S62","article-title":"Usefulness of indigo carmine chromoendoscopy and endoscopic clipping for accurate preoperative assessment of proximal gastric cancer","volume":"32","author":"T Okabayashi","year":"2000","journal-title":"Endoscopy"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1053\/j.gastro.2024.11.001","article-title":"AGA Clinical Practice Update on screening and surveillance in individuals at increased risk for gastric cancer in the United States: Expert Review","volume":"168","author":"SC Shah","year":"2025","journal-title":"Gastroenterology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"8540","DOI":"10.3390\/s22218540","article-title":"Unsupervised image-to-image translation: a review","volume":"22","author":"H Hoyez","year":"2022","journal-title":"Sensors (Basel)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2242","DOI":"10.1109\/iccv.2017.244","article-title":"Unpaired image-to-image translation using cycle-consistent adversarial networks","author":"JY Zhu","year":"2017","journal-title":"2017 IEEE International Conference on Computer Vision (ICCV)"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/s10120-024-01469-7","article-title":"Diagnostic performance of deep-learning-based virtual chromoendoscopy in gastric neoplasms","volume":"27","author":"S Suzuki","year":"2024","journal-title":"Gastric Cancer"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/jtehm.2021.3062226","article-title":"Stomach 3D reconstruction using virtual chromoendoscopic images","volume":"9","author":"AR Widya","year":"2021","journal-title":"IEEE J Transl Eng Health Med"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1055\/a-2779-0074","article-title":"Assessment of early gastric cancer visibility in deep-learning-based virtual indigo carmine chromoendoscopy (with video)","volume":"14","author":"A Takasu","year":"2026","journal-title":"Endosc Int Open"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10120-022-01331-8","article-title":"Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition)","volume":"26","author":"Japanese Gastric Cancer Association","year":"2023","journal-title":"Gastric Cancer"},{"key":"ref12","volume-title":"Japanese Classification of Gastric carcinoma. 15th edn","author":"Japanese Gastric Cancer Association","year":"2017"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1055\/s-0028-1098086","article-title":"An endoscopic recognition of the atrophic border and its significance in chronic gastritis","volume":"1","author":"K Kimura","year":"1969","journal-title":"Endoscopy"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"7884","DOI":"10.3748\/wjg.v21.i25.7884","article-title":"Diagnostic performance of magnifying narrow-band imaging for early gastric cancer: A meta-analysis","volume":"21","author":"YY Hu","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5543556","article-title":"Diagnostic ability of magnifying narrow-band imaging for the extent of early gastric cancer: a systematic review and meta-analysis","volume":"2021","author":"Y Hu","year":"2021","journal-title":"Gastroenterol Res Pract"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.3390\/medicina61091613","article-title":"Narrow-band imaging for the detection of early gastric cancer among high-risk patients: a systematic review and meta-analysis","volume":"61","author":"M Manti","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.14309\/ajg.0000000000002871","article-title":"Comparison of effective imaging modalities for detecting gastric neoplasms: a randomized 3-arm phase ii trial","volume":"119","author":"T Kadota","year":"2024","journal-title":"Am J Gastroenterol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1136\/gutjnl-2019-319631","article-title":"Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging","volume":"70","author":"N Yoshida","year":"2021","journal-title":"Gut"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1016\/j.gie.2024.06.013","article-title":"Virtual indigo carmine chromoendoscopy images: a novel modality for peroral cholangioscopy using artificial intelligence technology (with video)","volume":"100","author":"R Sato","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1111\/jgh.16843","article-title":"Development of deep learning-based virtual Lugol chromoendoscopy for superficial esophageal squamous cell carcinoma","volume":"40","author":"Y Toya","year":"2025","journal-title":"J Gastroenterol Hepatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1111\/jgh.16429","article-title":"Artificial intelligence-aided diagnostic imaging: A state-of-the-art technique in precancerous screening","volume":"39","author":"YB Lu","year":"2024","journal-title":"J Gastroenterol Hepatol"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2873-4466.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:37:53Z","timestamp":1784759873000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2873-4466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":21,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2026,7,22]]},"published-print":{"date-parts":[[2026,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2873-4466","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,8]]},"published":{"date-parts":[[2026,5,8]]}}}