Objective Endoscopic Analysis with Linked Color Imaging regarding Gastric Mucosal Atrophy: A Pilot Study

Abstract

Objectives We aimed to determine whether linked color imaging (LCI), a new image-enhanced endoscopy that enhances subtle differences in mucosal colors, can distinguish the border of endoscopic mucosal atrophy. Methods This study included 30 patients with atrophic gastritis. In endoscopy, we continuously took images in the same composition with both LCI and white light imaging (WLI). In each image, the color values of atrophic and nonatrophic mucosae were quantified using the International Commission on Illumination 1976 (L∗, a∗, b∗) color space. Color differences at the atrophic border, defined as Euclidean distances of color values between the atrophic and nonatrophic mucosae, were compared between WLI and LCI for the overall cohort and separately for patients with Helicobacter pylori infection status. Results We found that the color difference became significantly higher with LCI than with WLI in the overall samples of 90 points in 30 patients. LCI was 14.79 ± 6.68, and WLI was 11.06 ± 5.44 (P < 0.00001). LCI was also more effective in both of the Helicobacter pylori-infected group (P = 0.00003) and the Helicobacter pylori-eradicated group (P = 0.00002). Conclusions LCI allows clear endoscopic visualization of the atrophic border under various conditions of gastritis, regardless of Helicobacter pylori infection status.

RGB Pixel Brightness Characteristics of Linked Color Imaging in Early Gastric Cancer: A Pilot Study

“…Whether the patient has HP infection or not, the RGB distribution of EGC differs from the surrounding mucosa. Another study with Lab mode revealed that LCI allowed clear endoscopic visualization of the atrophic border, whether it has an HP-infected or HP-eradicated status [20]. This result is similar with our study.…”

Lavender Color in Linked Color Imaging Enables Noninvasive Detection of Gastric Intestinal Metaplasia

“…LCI is advantageous for improving the visibility of neoplastic lesions and for the evaluation of background mucosa and inflammation, especially neoplastic lesions in ulcerative colitis and GIM [13][14][15][30][31][32][33]. This is the first report on the detection of GIM using LCI; however, our study has some limitations.…”

Can image‐enhanced endoscopy improve the diagnosis of Kyoto classification of gastritis in the clinical setting?

“…Linked color imaging is a color enhancement technology that provides slight color differences in mucosal color which are easy to recognize with sufficient brightness compared with BLI and BLI‐bright. The color difference around the atrophic border became significantly higher with LCI than with WLI regardless of H. pylori infection status . LCI identified diffuse redness of the fundus as a crimson red color (Fig.…”

“…The color difference around the atrophic border became significantly higher with LCI than with WLI regardless of H. pylori infection status. 52 LCI identified diffuse redness of the fundus as a crimson red color (Fig. 3A,B).…”