Clinical Applications of Linked Color Imaging and Blue Laser/Light Imaging in the Screening, Diagnosis, and Treatment of Superficial Colorectal Tumors

Abstract

Considering its contribution to reducing colorectal cancer morbidity and mortality, the most important task of colonoscopy is to find all existing polyps. Moreover, the accurate detection of existing polyps determines the risk of colorectal cancer morbidity and is an important factor in deciding the appropriate surveillance program for patients. Image-enhanced endoscopy is an easy-touse modality with improved lesion detection. Linked color imaging (LCI) and blue laser/light imaging (BLI) are useful modalities for improving colonoscopy quality. Each mode has unique optical features; therefore, their intended use differs. LCI contributes to improved polyp detection due to its brightness and high color contrast between the lesion and normal mucosa, while BLI contributes to the characterization of detected polyps by evaluating the vessel and surface patterns of detected lesions. The proper use of these observation modes allows for more efficient endoscopic diagnosis. Moreover, recent developments in artificial intelligence will soon change the clinical practice of colonoscopy and this system will provide an efficient education modality for novice endoscopists. Clin Endosc 2021 Jul 14. [Epub ahead of print]

Linked-color imaging with or without artificial intelligence for adenoma detection: a randomized trial

“…Image-enhanced endoscopy has recently been developed to improve the ADR in daily practice, and linked color imaging (LCI) has attracted particular attention (Figure 1). The LASEREO laser endoscope (Fujifilm, Tokyo, Japan) combines two short-wavelength laser beams (410 nm and 450 nm) and a phosphor excited by a 450-nm laser output to enable white light, blue laser imaging, and LCI observations [6]. Recent studies have indicated that using LCI increases background blood vessel visibility and enhances reddish hues; therefore, redness associated with inflammation, polyps, and cancer is enhanced, improving the ADR [7,8].…”

Role of linked color imaging for upper gastrointestinal disease: present and future

“…It can project several images such as WLI, BLI, LCI, and BLI-bright (BLI-brt). 1 , 2 In WLI, blue, green, and red lights are combined to create a clear image. High contrast is maintained using blue-violet light (short wavelength, 410 nm).…”

Images of laser and light‐emitting diode colonoscopy for comparing large colorectal lesion visibility with linked color imaging and white‐light imaging

“…7,8 Many studies have shown the efficacy of lesion visibility and polyp detection under LCI observation. [9][10][11][12][13][14][15] On the other hand, an endoscope with a light-emitting diode (LED) light source (ELUXEO; Fujifilm) has been marketed since 2017 in the West and since 2020 in Japan. 16,17 Multilight technology from four-color LED lights (blue-violet, blue, green, and red) provides BLI and LCI.…”

“…Subsequently, linked color imaging (LCI) was developed and LCI has a brighter view and yellowish residual liquid in poor preparation, making neoplastic lesions and inflammatory areas reddish 7,8 . Many studies have shown the efficacy of lesion visibility and polyp detection under LCI observation 9–15 …”