Linked Color Imaging Can Improve Detection Rate of Early Gastric Cancer in a High-Risk Population: A Multi-Center Randomized Controlled Clinical Trial

Gao, Jie; Zhang, Xiaofeng; Meng, Qianqian; Jin, Hangbin; Zhu, Zhenhua; Wang, Zhijie; Qian, Wei; Zhang, Luoman; Liu, Yan; Min, Min; Chen, Xing; Chen, Haihua; Han, Sileny; Xiao, Jun; Wang, Yalei; Han, Wei; Lu, Yu‐Chuan; Cai, Shanshan; Chen, Weiqing; Ji, Wen; Xiao, Xuejun; Zheng, Qianqian; Zhang, Beiping; Wu, Wenbin; Lian, Guanghui; Liu, Xiaowei; Zhao, Qiu; Chen, Min; Zhuang, Kun; Si, Wangli; Shi, Xingang; Chen, Youxiang; Li, Zhao‐Shen; Wang, Dong

doi:10.1007/s10620-020-06289-0

Cited by 32 publications

(38 citation statements)

References 14 publications

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“…This may limit the applicability in patients undergoing surveillance gastroscopy following previous resections (who represent the high‐risk population for recurrence of gastric cancer precursors). However, a multicenter RCT recently conducted by Gao et al 11 . in a high‐risk population (including patients with previous endoscopic resection of EGC) showed a significant higher detection rate of EGC when gastroscopy was performed with both LCI and WLI, compared with WLI alone.…”

Section: Discussionmentioning

confidence: 96%

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A prospective randomized tandem gastroscopy pilot study of linked color imaging versus white light imaging for detection of upper gastrointestinal lesions

Namasivayam

et al. 2021

J of Gastro and Hepatol

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Background and Aim Gastrointestinal (GI) lesions may have subtle morphological changes. Linked color imaging (LCI) combines narrow‐band wavelength light and white light imaging (WLI) in appropriate balance to enhance lesion detection. We compared the detection rates of upper GI lesions using LCI and WLI. Method Patients were randomized in a 1:1 ratio to receive tandem gastroscopy with WLI inspection followed by LCI, or vice versa. Endoscopic examination was performed using the EG‐L590ZW gastroscope and the LASEREO endoscope system (Fujifilm Co., Tokyo, Japan). Histology was reported by a specialist GI pathologist blinded to the technique of lesion detection and was used as the gold standard for diagnosis. Results Ninety patients (mean age 66.8 years, 51.5% male patients) were randomized to either LCI examination first followed by WLI (LCI‐WLI), or vice versa (WLI‐LCI). An 18.9% of gastroscopies in the study were for surveillance of previously known gastric cancer precursors. Ten patients (11.1%) had a history of Helicobacter pylori infection. There was no significant difference in the time taken for examination under LCI (311 ± 96 s) and WLI (342 ± 86 s) (P = 0.700). LCI detection rates were higher than WLI detection rates for gastric cancer precursors such as atrophic gastritis (2.19% vs 0.55%) (P < 0.01) and intestinal metaplasia (19.73% vs 7.67%) (P < 0.01). Both sensitivity (82.74% vs 50.96%) and specificity (98.71% vs 96.10%) of LCI were higher than WLI for detection of upper GI lesions. Conclusions Linked color imaging had better detection rates, sensitivity, and specificity for detection of upper GI lesions compared with WLI.

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Section: Discussionmentioning

confidence: 96%

“…Linked color imaging has been proven to enhance detection of colorectal neoplasms and EGC in high‐risk populations 10,11 . However, there is lack of evidence for comparison of WLI and LCI for detection of upper GI lesions and gastric cancer precursors especially in lower risk populations such as Singapore.…”

Section: Introductionmentioning

confidence: 99%

A prospective randomized tandem gastroscopy pilot study of linked color imaging versus white light imaging for detection of upper gastrointestinal lesions

Namasivayam

et al. 2021

J of Gastro and Hepatol

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“…Until recently, there have been no prospective studies on the detection of gastric cancer. However, very recently, Gao et al conducted a randomized trial comparing gastric cancer detection rates in the LCI+WLI and WLI groups and reported that the detection rate of gastric cancers was higher in the LCI+WLI group than in the WLI group [ 29 ]. Our results on the usefulness of LCI for EAC suggest that LCI may be useful in the detection of EAC as well, and similar prospective randomized controlled trials are desirable in the future.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma

Tokunaga

Matsumura

Ishikawa

et al. 2020

Gastroenterology Research and Practice

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Background. The present study aimed to evaluate the efficacy of linked color imaging (LCI) in diagnosing Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Methods. A total of 112 and 12 consecutive patients with BE and EAC were analyzed. The visibility scores of BE and EAC ranging from 4 (excellent visibility) to 0 (not detectable) were evaluated by three trainees and three experts using white light imaging (WLI), LCI mode, and blue laser imaging bright (BLI-b) mode. In addition, L ∗ a ∗ b ∗ color values and color differences ( Δ E ∗ ) were evaluated using the CIELAB color space system. Results. The visibility score of the BE in LCI mode ( 2.94 ± 1.32 ) was significantly higher than those in WLI ( 2.46 ± 1.48 ) and BLI-b mode ( 2.35 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent gastric mucosa in LCI mode ( 17.11 ± 8.53 ) was significantly higher than those in other modes ( 12.52 ± 9.37 in WLI and 11.96 ± 6.59 in BLI-b mode, p < 0.01 ). The visibility scores of EAC in LCI mode ( 2.56 ± 1.47 ) and BLI-b mode ( 2.51 ± 1.28 ) were significantly higher than that in WLI ( 1.64 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent normal Barrett’s mucosa in LCI mode ( 19.96 ± 7.97 ) was significantly higher than that in WLI ( 12.95 ± 11.86 ) ( p = 0.03 ). Conclusion. The present findings suggest that LCI increases the visibility of BE and EAC and contributes to the improvement of the detection of these lesions.

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“…Two randomized controlled trials improved the detection of gastric neoplasms. 88,89 Additionally, it is relatively easy to use as one trial showed that there was no difference in sensitivity between experts and non-experts. 88 Although likely not used for staging, these can be useful in screening for both primaries and recurrence.…”

Section: Current Imaging Modalitiesmentioning

confidence: 99%

“…These techniques generally involve magnification of the mucosa and color enhancement with lasers, making the difference between normal mucosa and lesions. Two randomized controlled trials improved the detection of gastric neoplasms 88,89 . Additionally, it is relatively easy to use as one trial showed that there was no difference in sensitivity between experts and non‐experts 88 .…”

Section: Role Of Imaging In Restagingmentioning

confidence: 99%

Current and future imaging modalities in gastric cancer

Tham

Sestito

Markovich

et al. 2022

Journal of Surgical Oncology

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Gastric adenocarcinoma treatment can include endoscopic mucosal resection, surgery, chemotherapy, radiation, and palliative measures depending on staging. Both invasive and noninvasive staging techniques have been used to dictate the best treatment pathway. Here, we review the current imaging modalities used in gastric cancer as well as novel techniques to accurately stage and screen these patients.

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Linked Color Imaging Can Improve Detection Rate of Early Gastric Cancer in a High-Risk Population: A Multi-Center Randomized Controlled Clinical Trial

Cited by 32 publications

References 14 publications

A prospective randomized tandem gastroscopy pilot study of linked color imaging versus white light imaging for detection of upper gastrointestinal lesions

A prospective randomized tandem gastroscopy pilot study of linked color imaging versus white light imaging for detection of upper gastrointestinal lesions

The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma

Current and future imaging modalities in gastric cancer

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