{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:09:29Z","timestamp":1790834969256,"version":"4.1.0"},"reference-count":20,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T00:00:00Z","timestamp":1666569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This review of our experience in computer-assisted tissue image analysis (CATIA) research shows that significant information can be extracted and used to diagnose and distinguish normal from abnormal endometrium. CATIA enabled the evaluation and differentiation between the benign and malignant endometrium during diagnostic hysteroscopy. The efficacy of texture analysis in the endometrium image during hysteroscopy was examined in 40 women, where 209 normal and 209 abnormal regions of interest (ROIs) were extracted. There was a significant difference between normal and abnormal endometrium for the statistical features (SF) features mean, variance, median, energy and entropy; for the spatial grey-level difference matrix (SGLDM) features contrast, correlation, variance, homogeneity and entropy; and for the gray-level difference statistics (GLDS) features homogeneity, contrast, energy, entropy and mean. We further evaluated 52 hysteroscopic images of 258 normal and 258 abnormal endometrium ROIs, and tissue diagnosis was verified by histopathology after biopsy. The YCrCb color system with SF, SGLDM and GLDS color texture features based on support vector machine (SVM) modeling correctly classified 81% of the cases with a sensitivity and a specificity of 78% and 81%, respectively, for normal and hyperplastic endometrium. New technical and computational advances may improve optical biopsy accuracy and assist in the precision of lesion excision during hysteroscopy. The exchange of knowledge, collaboration, identification of tasks and CATIA method selection strategy will further improve computer-aided diagnosis implementation in the daily practice of hysteroscopy.<\/jats:p>","DOI":"10.3390\/ijms232112782","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T06:37:45Z","timestamp":1666593465000},"page":"12782","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Computer-Aided Diagnosis by Tissue Image Analysis as an Optical Biopsy in Hysteroscopy"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4695-4630","authenticated-orcid":false,"given":"Vasilios","family":"Tanos","sequence":"first","affiliation":[{"name":"Aretaeio Hospital, 55-57 Andrea Avraamides Street, Nicosia 2024, Cyprus"},{"name":"Medical School, Nicosia of University, 93 Agiou Nikolaou Street, Nicosia 2408, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Neofytou","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Biomedical Engineering Research Center, University of Cyprus, Nicosia 1678, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-0995","authenticated-orcid":false,"given":"Panayiotis","family":"Tanos","sequence":"additional","affiliation":[{"name":"Causeway Hospital, Coleraine BT51 3AE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1271-8151","authenticated-orcid":false,"given":"Constantinos S.","family":"Pattichis","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Biomedical Engineering Research Center, University of Cyprus, Nicosia 1678, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios S.","family":"Pattichis","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM 87131, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,24]]},"reference":[{"key":"ref_1","first-page":"S25","article-title":"Digital imaging in anatomic pathology","volume":"106","author":"Sotnikov","year":"1996","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_2","unstructured":"(2022, October 11). STORZ Telescopes. Available online: www.karlstorz.com."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/S0140-6736(94)90412-X","article-title":"Three-dimensional video-endoscopy: Clinical use in gynaecological laparoscopy","volume":"344","author":"Wenzl","year":"1994","journal-title":"Lancet"},{"key":"ref_4","first-page":"660","article-title":"Comparison of different treatment methods of endometriomas by laparoscopy","volume":"78","author":"Fayez","year":"1991","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1475-925X-2-9","article-title":"Feature extraction for the analysis of colon status from the endoscopic images","volume":"2","author":"Tjoa","year":"2003","journal-title":"BioMedical Eng. OnLine"},{"key":"ref_6","unstructured":"Karkanis, S., Galousi, K., and Maroulis, D. (1999). Classification of endoscopic images based on texture spectrum. Workshop on Machine Learning in Medical Applications."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1475-925X-6-44","article-title":"A standardised protocol for texture feature analysis of endoscopic images in gynaecological cancer","volume":"6","author":"Neofytou","year":"2007","journal-title":"BioMedical Eng. OnLine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1109\/JBHI.2014.2332760","article-title":"Computer-aided diagnosis in hysteroscopic imaging","volume":"19","author":"Neofytou","year":"2014","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1109\/RBME.2009.2034865","article-title":"Histopathological image analysis: A review","volume":"2","author":"Gurcan","year":"2009","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"015001","DOI":"10.1117\/1.JMI.4.1.015001","article-title":"Tissue classification for laparoscopic image understanding based on multispectral texture analysis","volume":"4","author":"Zhang","year":"2017","journal-title":"J. Med. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.gie.2012.02.003","article-title":"Characterization of buried glands before and after radiofrequency ablation by using 3-dimensional optical coherence tomography (with videos)","volume":"76","author":"Zhou","year":"2012","journal-title":"Gastrointest. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Munzenmayer, C., Winter, C., Rupp, S., Kage, A., and Wittenberg, T. (2009, January 3\u20136). Texture-based computer-assisted diagnosis for fiberscopic images. Proceedings of the 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Minneapolis, MN, USA.","DOI":"10.1109\/IEMBS.2009.5334879"},{"key":"ref_13","unstructured":"(2022, October 11). The Edmund Optics Company. Available online: www.edmundoptics.com."},{"key":"ref_14","unstructured":"(2022, October 11). The ACMI Corporation. Available online: www.acmicorp.com."},{"key":"ref_15","unstructured":"(2022, October 11). The Pinnacle Systems Company. Available online: www.pinnaclesys.com."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Long, L.R., Antani, S., Jeronimo, J., Schiffman, M., Bopf, M., Neve, L., Cornwell, C., Budihas, S.R., and Thoma, G.R. (2006, January 22\u201323). Technology for medical education, research, and disease screening by exploitation of biomarkers in a large collection of uterine cervix images. Proceedings of the 19th IEEE Symposium on Computer-Based Medical Systems (CBMS\u201906), Salt Lake City, UT, USA.","DOI":"10.1109\/CBMS.2006.154"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Scharcanski, J., and Gaviao, W. (2006, January 8\u201311). Hierarchical summarization of diagnostic hysteroscopy videos. Proceedings of the 2006 International Conference on Image Processing, Atlanta, GA, USA.","DOI":"10.1109\/ICIP.2006.312376"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/sj.neo.7900071","article-title":"Optical coherence tomography: An emerging technology for biomedical imaging and optical biopsy","volume":"2","author":"Fujimoto","year":"2000","journal-title":"Neoplasia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1109\/TSMC.1973.4309314","article-title":"Textural features for image classification","volume":"6","author":"Haralick","year":"1973","journal-title":"IEEE Trans. Syst. Man Cybern."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1055\/s-0043-124080","article-title":"Detection of early neoplasia in Barrett\u2019s esophagus using lectin-based near-infrared imaging: An ex vivo study on human tissue","volume":"50","author":"Neves","year":"2018","journal-title":"Endoscopy"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/21\/12782\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:30Z","timestamp":1760144490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/21\/12782"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,24]]},"references-count":20,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["ijms232112782"],"URL":"https:\/\/doi.org\/10.3390\/ijms232112782","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,24]]}}}