Linked Color Imaging Reduces the Miss Rate of Neoplastic Lesions in the Right Colon: A Randomized Tandem Colonoscopy Study

Paggi, Silvia; Mogavero, Giuseppe; Amato, Antonio; Andrealli, Alida; Imperiali, G.; Lenoci, Nicoletta; Mandelli, Giovanni; Rondonotti, Emanuele; Terreni, Natalia; Spinzi, G; Radaelli, Franco

doi:10.1055/s-0038-1637068

Cited by 12 publications

(17 citation statements)

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“…The result that BLI and LCI improved the detection of colorectal lesions compared with WLI has been described in previous RCT. 9,11,12 In the present study, we adopted the eye-tracking system to assess the detection of colorectal lesions, and our result was consistent with that of previous RCT. There was no difference in the miss rate and detection time of colorectal lesions between BLI-bright and LCI in our study.…”

Section: Discussionsupporting

confidence: 87%

“…The result that BLI and LCI improved the detection of colorectal lesions compared with WLI has been described in previous RCT …”

Section: Discussionsupporting

confidence: 54%

“…LCI images enhance differences in the hue of the red region of the spectrum, making red areas appear redder and white areas appear whiter . LCI images are reported to improve the detection of gastrointestinal neoplastic lesions compared to WLI …”

Section: Introductionmentioning

confidence: 99%

“…10 LCI images are reported to improve the detection of gastrointestinal neoplastic lesions compared to WLI. 11,12 No randomized controlled trial (RCT) has investigated whether BLI-bright or LCI is more useful for the detection of colorectal lesions. In some recent studies, improvement of visibility with LCI compared to BLI-bright has been reported.…”

Section: Introductionmentioning

confidence: 99%

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Objective evaluation of the visibility of colorectal lesions using eye tracking

Kumahara

Ikematsu

Shinmura

et al. 2019

Digestive Endoscopy

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Background and Aim To assess the visibility of colorectal lesions using blue laser imaging (BLI)‐bright and linked‐color imaging (LCI) with an eye‐tracking system. Methods Eleven endoscopists evaluated 90 images of 30 colorectal lesions. The lesions were randomly selected. Three images of each lesion comprised white light imaging (WLI), BLI‐bright, and LCI in the same position. Participants gazed at the images, and their eye movements were tracked by the eye tracker. We analyzed whether the participants could detect the lesion and how long they took to detect the lesion. We assessed the miss rate and detection time among the imaging modalities. Results One endoscopist was excluded, and 10 endoscopists were assessed. Overall, 12.6% of lesions were missed with WLI, 6.0% with BLI‐bright, and 4.3% with LCI; the miss rate of BLI‐bright and LCI was significantly lower than that of WLI (P < 0.01), with no significant difference between the former modalities (P = 0.54). Mean (± SD) detection times were 1.58 ± 1.60 s for WLI, 1.01 ± 1.21 s for BLI‐bright, and 1.10 ± 1.16 s for LCI. Detection time for BLI‐bright and LCI was significantly shorter than that for WLI (P < 0.0001), with no significant difference between the former modalities (P = 0.34). Regarding the miss rate and detection time between the expert and the non‐experts, there was a significant difference with WLI but not with BLI‐bright and LCI. Conclusion Blue laser imaging‐bright and LCI improved the detection of colorectal lesions compared with WLI using an eye‐tracking system.

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Section: Discussionsupporting

confidence: 87%

“…The result that BLI and LCI improved the detection of colorectal lesions compared with WLI has been described in previous RCT …”

Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Objective evaluation of the visibility of colorectal lesions using eye tracking

Kumahara

Ikematsu

Shinmura

et al. 2019

Digestive Endoscopy

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“…Laser endoscopy (Fujifilm Medical Systems) uses not only blue laser imaging with the bright (BLI‐bright) mode, enabling observation of the gastric lumen more brightly than when using the BLI mode, but also the linked color imaging (LCI) mode, which enhances reddish colors 18 . BLI and LCI have been reported to be superior to WLI for detection of gastric cancers 18–29 and colorectal tumors 30–33 ; however, this was determined retrospectively comparing images using LCI and WLI. Min et al .…”

Section: Introductionmentioning

confidence: 99%

Detection of early stage gastric cancers in screening laser endoscopy using linked color imaging for patients with atrophic gastritis

Yamaoka

Imaeda

Miyaguchi

et al. 2020

J of Gastro and Hepatol

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Background and Aims Laser endoscopy involves blue laser imaging in bright mode (BLI‐bright). Linked color imaging (LCI) is superior to white light imaging (WLI) for detecting gastric cancers. This study aimed to detect gastric cancers on screening endoscopy using not only WLI but also BLI‐bright and LCI in patients with atrophic gastritis. Patients and Methods A total of 500 patients with atrophic gastritis undergoing screening esophagogastroduodenoscopy were included. The gastric lumen was observed in the WLI mode, followed by the LCI and BLI‐bright modes. When gastric neoplasms were suspected, the mode was changed to WLI, and we sprayed indigo carmine. Finally, biopsy specimens were taken for those lesions and pathological diagnosis was made. We compared the size, morphology, and color of gastric neoplasms found by the first WLI mode and those detected by only the LCI mode or BLI‐bright mode. Results We detected 16 gastric neoplasms (3.2%), of which 13 were early gastric cancers (EGCs) and three were gastric adenomas. Ten EGCs and two gastric adenomas (75%) were detected by the first WLI mode; three EGCs and one gastric adenoma (25%) were missed by the first WLI mode and were detected by the LCI mode or BLI‐bright mode. All were less than 1 cm in diameter and were reddish. Mean diameter of the lesions was significantly less for LCI‐detected or BLI‐bright‐detected lesions than for WLI‐detected lesions (7.8 vs 21.2 mm). Conclusions Laser endoscopy is useful for detecting EGCs by LCI for patients with atrophic gastritis.

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Blue-light imaging and linked-color imaging improve visualization of Barrett’s neoplasia by nonexpert endoscopists

Groof

Fockens

Struyvenberg

et al. 2020

Gastrointestinal Endoscopy

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Background and Aims: Endoscopic recognition of early Barrett's neoplasia is challenging. Blue-light imaging (BLI) and linked-color imaging (LCI) may assist endoscopists in appreciation of neoplasia. Our aim was to evaluate BLI and LCI for visualization of Barrett's neoplasia in comparison with white-light endoscopy (WLE) alone, when assessed by nonexpert endoscopists.Methods: In this web-based assessment, corresponding WLE, BLI, and LCI images of 30 neoplastic Barrett's lesions were delineated by 3 expert endoscopists to establish ground truth. These images were then scored and delineated by 76 nonexpert endoscopists from 3 countries and with different levels of expertise, in 4 separate assessment phases with a washout period of 2 weeks. Assessments were as follows: assessment 1, WLE only; assessment 2, WLE þ BLI; assessment 3, WLE þ LCI; assessment 4, WLE þ BLI þ LCI. The outcomes were (1) appreciation of macroscopic appearance and ability to delineate lesions (visual analog scale [VAS] scores); (2) preferred technique (ordinal scores); and (3) assessors' delineation performance in terms of overlap with expert ground truth.Results: Median VAS scores for phases 2 to 4 were significantly higher than in phase 1 (P < .001). Assessors preferred BLI and LCI over WLE for appreciation of macroscopic appearance (P < .001) and delineation (P < .001). Linear mixed-effect models showed that delineation performance increased significantly in phase 4. Conclusions:The use of BLI and LCI has significant additional value for the visualization of Barrett's neoplasia when used by nonexpert endoscopists. Assessors appreciated the addition of BLI and LCI better than the use of WLE alone. Furthermore, this addition led to improved delineation performance, thereby allowing for better acquisition of targeted biopsy samples.

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Linked Color Imaging Reduces the Miss Rate of Neoplastic Lesions in the Right Colon: A Randomized Tandem Colonoscopy Study

Cited by 12 publications

References 0 publications

Objective evaluation of the visibility of colorectal lesions using eye tracking

Objective evaluation of the visibility of colorectal lesions using eye tracking

Detection of early stage gastric cancers in screening laser endoscopy using linked color imaging for patients with atrophic gastritis

Blue-light imaging and linked-color imaging improve visualization of Barrett’s neoplasia by nonexpert endoscopists

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