Blue-light imaging compared with high-definition white light for real-time histology prediction of colorectal polyps less than 1 centimeter: a prospective randomized study

Background: Optical diagnosis of colorectal polyps (CRPs) remains challenging. Imaging enhancement techniques such as narrow band imaging and blue light imaging (BLI) can improve optical diagnosis. We developed and prospectively validated a computer-aided diagnosis system (CADx) using high definition white light (HDWL) and BLI images, and compared it with the optical diagnosis of expert and novice endoscopists. Methods: The CADx characterized CRPs by exploiting artificial neural networks. Six experts and thirteen novices optically diagnosed 60 CRPs based on intuition. After a washout period of four weeks, the same set of CRPs was permuted and optically diagnosed using BASIC (BLI Adenoma Serrated International Classification). Results: The CADx had a diagnostic accuracy of 88.3% using HDWL images and 86.7% using BLI images. The overall diagnostic accuracy, combining HDWL and BLI (multimodal imaging), was 95.0% and significantly higher compared to experts (81.7%, p=0.031) and novices (66.5%, p<0.001). Sensitivity (95.6% vs. 61.1% and 55.4%) was also higher for CADx, while specificity was higher for experts compared to CADx and novices (94.1% vs 93.3% and 92.1%). For endoscopists, diagnostic accuracy did not increase using BASIC, neither for experts (Intuition 79.5% vs BASIC 81.7%, p=0.140) nor for novices (Intuition 66.7% vs BASIC 66.5%, p=0.953). Conclusion: The CADx had a significantly higher diagnostic accuracy than experts and novices for the optical diagnosis of CRPs. Multimodal imaging, incorporating both HDWL and BLI, improved the diagnostic accuracy of the CADx. BASIC did not increase the diagnostic accuracy of endoscopists compared to intuitive optical diagnosis.

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“…Winkens 5 , P. Aepli 6 , B. Hayee 7 , A.B. Pischel 8 , M. Stefanovic 9 , S. Subramaniam 10 , P. Bhandari 10…”

Section: Improving Optical Diagnosis Of Colorectal Polyps Using Compumentioning

confidence: 99%

Optical diagnosis of colorectal polyp images using a newly developed computer-aided diagnosis system (CADx) compared with intuitive optical diagnosis

et al. 2020

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“…Only a few studies have reported the efficacy of LED-BLI for tumor characterization because the LED-BLI is a novel endoscopic system [20,25]. Recently, a European group proposed the BASIC classification for colorectal polyp characterization with LED-BLI [20].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Diagnostic Ability of Magnifying Blue Light Imaging with a Light Emitting Diode Light Source for Early Gastric Cancer: A Prospective Comparative Study

et al. 2019

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Introduction: An innovative endoscopic system using 4-color light-emitting diodes (LED) was released between 2016 and 2017 in locations that had not approved laser endoscopes for use, including the United States and Europe. Objective: This study compared the diagnostic efficacy between magnifying blue light imaging with an LED light source (LED-BLI) and magnifying blue laser imaging with a laser light source (Laser-BLI) for early gastric cancer (EGC). Methods: In this prospective, single-center, noninferiority study, 80 gastric lesions were evaluated between January 2017 and July 2017. The magnifying findings of gastric lesions – including the demarcation line (DL), microvascular pattern (MVP), and microsurface pattern (MSP) – were evaluated using Laser-BLI and LED-BLI according to the vessel plus surface classification system (VSCS). The primary end point was to determine whether the diagnostic accuracy of LED-BLI for EGC was noninferior to that of conventional Laser-BLI. Results: Overall, we evaluated 79 gastric lesions histopathologically diagnosed as adenocarcinomas from the specimens obtained via endoscopic submucosal dissection. A DL was observed by Laser-BLI and LED-BLI in 98.7% (78/79) and 96.2% (76/79) of EGCs, respectively. The MVP observed using Laser-BLI and LED-BLI was irregular in 92.4% (73/79) and 89.9% (71/79), respectively. The MSP observed using Laser-BLI and LED-BLI was irregular in 83.5% (66/79) and 82.2% (65/79), respectively. According to the VSCS, diagnosable cancers were found in 94.9% (75/79) and 93.7% (74/79) of cases when using Laser-BLI and LED-BLI, respectively (p = 0.73; difference ratio, 1.2%; 95% CI –8.5 to 6.0%). Conclusions: LED-BLI could accurately visualize the DL, MVP, and MSP of EGCs and was not inferior to Laser-BLI. Therefore, LED-BLI can be used to diagnose EGC accurately according to the VSCS-based diagnosis criteria.

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“…Blue light imaging (BLI) is a new IEE system released by Fujifilm [15,16]. It focuses on the characteristics of short wavelength absorption of hemoglobin (at 410 nm) combined with specific white light spectral colors.…”

Section: Virtual Chromoendoscopymentioning

confidence: 99%

Image-Enhanced Endoscopy in Lower Gastrointestinal Diseases: Present and Future

Lee

2018

Clin Endosc

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From dye-assisted conventional chromoendoscopy to novel virtual chromoendoscopy, image-enhanced endoscopy (IEE) is continuously evolving to meet clinical needs and improve the quality of colonoscopy. Dye-assisted chromoendoscopy using indigo carmine or crystal violet, although slightly old-fashioned, is still useful to emphasize the pit patterns of the colonic mucosa and predict the histological structures of relevant lesions. Equipment-based virtual chromoendoscopy has the advantage of being relatively easy to use. There are several types of virtual chromoendoscopy that vary depending on the manufacturer and operating principle. IEE plays distinctive roles with respect to histologic characterization of colorectal polyps and prediction of the invasion depth of colorectal cancers. In addition, the newest models of IEE have the potential to increase adenoma and polyp detection rates in screening colonoscopy.

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Blue-light imaging compared with high-definition white light for real-time histology prediction of colorectal polyps less than 1 centimeter: a prospective randomized study

Cited by 30 publications

References 27 publications

Optical diagnosis of colorectal polyp images using a newly developed computer-aided diagnosis system (CADx) compared with intuitive optical diagnosis

Optical diagnosis of colorectal polyp images using a newly developed computer-aided diagnosis system (CADx) compared with intuitive optical diagnosis

Diagnostic Ability of Magnifying Blue Light Imaging with a Light Emitting Diode Light Source for Early Gastric Cancer: A Prospective Comparative Study

Image-Enhanced Endoscopy in Lower Gastrointestinal Diseases: Present and Future

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