Enhanced Visibility in Evaluating Gastric Cancer and Helicobacter pylori-Associated Gastritis Using Linked Color Imaging with a Light-Emitting Diode Light Source

Ishida, Tsugitaka; Dohi, Osamu; Yoshida, Naohisa; Yasuda, Takeshi; Yoshida, Takuma; Azuma, Yuka; Kitae, Hiroaki; Matsumura, Shinya; Doi, Takehiko; Hirose, Ryohei; Inoue, Ken; Kamada, Kazuhiro; Uchiyama, Kazuhiko; Ishikawa, Takeshi; Takagi, Tomohisa; Konishi, Hideyuki; Naito, Yuji; Itoh, Yoshito

doi:10.1007/s10620-021-07234-5

Cited by 12 publications

(15 citation statements)

References 25 publications

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“…Second, although we tried to exclude images that might lead to bias, images from the exact same angle and distance might not be available for both WLI and LCI due to patient movement, gastric motility, and gas insufflation. Third, the visual scores were subjectively made by endoscopists and the interobserver agreement was slightly lower than in previous reports 6,10 . The present study also has important strengths.…”

Section: Discussionmentioning

confidence: 63%

“…Several studies have reported that LCI has the advantage of improving the visibility of gastrointestinal malignant lesions with a higher score than WLI 5–9 . LCI with light‐emitting diode light source (LED) endoscopy has been reported to be efficient for the detection of EGCs 10 . In a recent prospective trial, LCI drastically decreased the miss rate of cancers in the upper gastrointestinal tract 11 .…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of linked color imaging for the detection of obscure early gastric cancer: Multivariate analysis of 508 lesions

Khurelbaatar

Mıura

Osawa

et al. 2022

Digestive Endoscopy

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Objectives Early gastric cancers (EGCs) of the elevated type or with submucosal invasion are easily found by routine endoscopy. However, most early cancers are challenging to detect because of subtle morphological or color differences from surrounding atrophic mucosa and intestinal metaplasia. Linked color imaging (LCI) enhances mucosal color difference, making it easier to detect EGCs. The aim of this study is to clarify the advantages and possible disadvantages of LCI for screening for obscure EGC. Methods A total of 665 malignant gastric lesions resected using endoscopic submucosal dissection between January 2015 and April 2018 were retrospectively reviewed. Obviously detectable lesions were not included in the main analysis when determining the target lesion. White light imaging (WLI)/LCI images of 508 endoscopically obscure malignant lesions were included in the final analysis and evaluated by three non‐expert and three expert endoscopists using visibility scores for detection and extent. Results The detection visibility scores using LCI were significantly higher than those using WLI regardless of lesion characteristics including location, size, histological type, depth of invasion, and Helicobacter pylori status. The detection score improved in 46.4% cases and deteriorated in 4.9% when the modality changed from WLI to LCI. A mixed‐effects multivariate logistic regression analysis showed that use of LCI (odds ratio [OR] 2.57), elevated type (OR 1.92), invasion to submucosa (OR 2.18) were significantly associated with improved visibility of EGC. Conclusions Linked color imaging significantly improves visibility of EGC regardless of differences in lesion morphology, histology, location, depth of invasion, and H. pylori status compared to conventional WLI.

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Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Usefulness of linked color imaging for the detection of obscure early gastric cancer: Multivariate analysis of 508 lesions

Khurelbaatar

Mıura

Osawa

et al. 2022

Digestive Endoscopy

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“…We compared the tumor characterization function of the BLI-LED system to that of the BLI-LASER system by calculating the color difference values (CDVs) of each of the 37 lesions. We used the CIEL∗a∗b∗ color space and delta ELab formulas to calculate the CDV (delta ELab), as described in a previous report [ 6 , 16 ]. This value is used to evaluate whether an observer can detect a vessel in the color (differences can be detected clearly if the CDV is more than 5).…”

Section: Methodsmentioning

confidence: 99%

“…Another unique LED system, a compact light source-processor combined with an LED endoscopic system (ELUXEO Lite EP-6000, Fujifilm Co.) has been marketed since 2018 in Japan and Europe. We expected that multilight technology of LED endoscope, with three LED lights (blue violet, blue, and green red), could provide bright WLI, LCI, and BLI-LED as well as LASER endoscope, and a previous paper using this system with nonmagnification endoscope showed the efficacy of BLI and LCI for tumor detection and characterization regarding colorectal and gastric tumors [ 6 , 16 ]. This system is less expensive than a laser endoscope and standard LED systems.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Tumor Characterization for Colorectal Lesions with Blue Light Imaging of a Compact Light-Emitting Diode Endoscopic System Compared to a Laser Endoscopic System: A Pilot Study

Inoue

Yoshida

Kobayashi

et al. 2022

Gastroenterology Research and Practice

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Background: A compact and cost-effective light source-processor combined 3-color light-emitting diode (LED) endoscopic system (ELUXEO-Lite: EP-6000, Fujifilm Co., Tokyo) with a magnified colonoscope (EC-6600ZP, Fujifilm Co.) has been released. Aims: In this study, we analyzed the efficacy of this system for colorectal tumor characterization with magnified blue light imaging (BLI-LED) and image’s subjective and objective evaluations, compared to a magnified blue laser imaging (BLI-LASER) using a standard LASER endoscopic system. Methods: We retrospectively reviewed 37 lesions observed with both BLI-LED and BLI-LASER systems from 2019 using the Japanese narrow band imaging classification. Two representative magnified images, one BLI-LED and one BLI-LASER, of the same area of a lesion were evaluated for diagnostic accuracy and visualization quality by three experts and three non-experts. Their color difference values (CDVs) and brightness values (BVs) were also calculated as objective indicators. Results: Among 37 lesions, mean tumor size was 18.9 ± 13.1 mm, and 21 lesions were nonpolypoid. Histopathology revealed 14 sessile serrated lesions, 7 adenomas, 12 high-grade dysplasias and T1a cancers, and 4 T1b cancers. The diagnostic accuracy rates of BLI-LED/BLI-LASER of experts and non-experts were 90.1% and 87.4% ( p = 0.52 ) and 89.2% and 89.2% ( p = 0.99 ). The percentages of instances where BLI-LED images were better, the two imaging types were equivalent, or BLI-LASER images were better were 16%/83%/1% for experts and 19%/58%/23% for non-experts ( p < 0.001 ). CDVs and BVs between BLI-LED and BLI-LASER were not significantly different (CDVs: p = 0.653 , BVs: p = 0.518 ). Conclusions: BLI-LED using the compact system was noninferior to BLI-LASER for colorectal tumor characterization and image quality.

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“…In this issue of Digestive Diseases and Sciences, Ishida et al (2021) reported a comparison between laser and LED endoscopies in order to evaluate the enhanced visibility of EGC and H. pylori-associated gastritis [9]. Videos were taken of both methods being performed on 88 patients, evaluating 99 EGC lesions and the associated background gastric mucosa at a single center.…”

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confidence: 99%

In Living Color: Linked Color Imaging for the Detection of Early Gastric Cancer

2021

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Enhanced Visibility in Evaluating Gastric Cancer and Helicobacter pylori-Associated Gastritis Using Linked Color Imaging with a Light-Emitting Diode Light Source

Cited by 12 publications

References 25 publications

Usefulness of linked color imaging for the detection of obscure early gastric cancer: Multivariate analysis of 508 lesions

Usefulness of linked color imaging for the detection of obscure early gastric cancer: Multivariate analysis of 508 lesions

The Efficacy of Tumor Characterization for Colorectal Lesions with Blue Light Imaging of a Compact Light-Emitting Diode Endoscopic System Compared to a Laser Endoscopic System: A Pilot Study

In Living Color: Linked Color Imaging for the Detection of Early Gastric Cancer

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