Comparison Between Linked Color Imaging and Blue Laser Imaging for Improving the Visibility of Flat Colorectal Polyps: A Multicenter Pilot Study

Abstract

Introduction

Linked color imaging (LCI) and blue laser imaging-bright (BLI-b) improve the visibility of gastrointestinal lesions. In this multicenter study, we compared the effects of LCI and BLI-b on the visibility of flat polyps with visibility scores and color difference (CD) values, including fast-withdrawal and large-monitor observation.

Methods

We recorded 120 videos of 40 consecutive flat polyps (2–20 mm), adenoma, and sessile serrated adenoma and polyp (SSA/P), using white light imaging (WLI), BLI-b, and LCI from July 2017 to December 2017. All videos were evaluated by eight endoscopists according to a published polyp visibility score of 4 (excellent) to 1 (poor). Additionally, 1.5 ×faster and 1.7 ×sized videos were evaluated. Moreover, we calculated the CD values for each polyp in three modes.

Results

The mean LCI scores (3.1 ± 0.9) were significantly higher than the WLI scores (2.5 ± 1.0, p < 0.001) but not significantly higher than the BLI-b scores (3.0 ± 1.0). The scores of faster videos on LCI (3.0 ± 1.1) were significantly higher than WLI (2.0 ± 1.0, p < 0.001) and BLI-b (2.8 ± 1.1, p = 0.03). The scores of larger-sized videos on LCI were not significantly higher than those of WLI or BLI-b. The CD value of LCI (18.0 ± 7.7) was higher than that of WLI (11.7 ± 7.0, p < 0.001), but was not significantly higher than that of BLI-b (16.6 ± 9.6). The CD value of LCI was significantly higher than that of BLI-b for adenoma, but the CD value of BLI-b was significantly higher than that of LCI for SSA/P.

Conclusions

The superiority of LCI to BLI-b was proven for the visibility of adenoma and fast observation.

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References

  1. 1.

    Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993;329:1977–1981.

    CAS  Article  Google Scholar 

  2. 2.

    Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–696.

    CAS  Article  Google Scholar 

  3. 3.

    Heresbach D, Barrioz T, Lapalus MG, et al. Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies. Endoscopy. 2008;40:284–290.

    CAS  Article  Google Scholar 

  4. 4.

    Ikematsu H, Saito Y, Tanaka S, et al. The impact of narrow band imaging for colon polyp detection: a multicenter randomized controlled trial by tandem colonoscopy. J Gastroenterol. 2012;47:1099–1107.

    Article  Google Scholar 

  5. 5.

    Adler A, Pohl H, Papanikolaou IS, et al. A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect? Gut. 2008;57:59–64.

    CAS  Article  Google Scholar 

  6. 6.

    Rex DK, Helbig C. High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging. Gastroenterology. 2007;133:42–47.

    Article  Google Scholar 

  7. 7.

    Horimatsu T, Sano Y, Tanaka S, et al. Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial. Int J Colorectal Dis. 2015;30:947–954.

    Article  Google Scholar 

  8. 8.

    Ogiso K, Yoshida N, Siah KTH, et al. New Generation Narrow Band Imaging Improves Visibility of Polyps: A Colonoscopy Video Evaluation Study. J Gastroenterol. 2016;51:883–890.

    Article  Google Scholar 

  9. 9.

    Osawa H, Yamamoto H. Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology. Dig Endosc. 2014;26:105–115.

    Article  Google Scholar 

  10. 10.

    Yoshida N, Hisabe T, Inada Y, et al. The Ability of A Novel Blue Laser Imaging System for the Diagnosis of Invasion Depth of Colorectal Neoplasms. J Gastroenterol. 2014;49:73–80.

    Article  Google Scholar 

  11. 11.

    Yoshida N, Yagi N, Inada Y, et al. The Ability of A Novel Blue Laser Imaging System for the Diagnosis of Colorectal Polyps. Dig Endosc. 2014;26:250–258.

    Article  Google Scholar 

  12. 12.

    Yoshida N, Hisabe T, Hirose R, et al. Improvement in the visibility of colorectal polyps by using blue laser imaging. Gastrointest Endosc. 2015;82:542–549.

    Article  Google Scholar 

  13. 13.

    Ikematsu H, Sakamoto T, Togashi K, et al. Detectability of colorectal neoplastic lesions using a novel endoscopic system with blue laser imaging: a multicenter randomized controlled trial. Gastointest Endosc. 2017;86:386–394.

    Article  Google Scholar 

  14. 14.

    Yoshida N, Naito Y, Murakami T, et al. Linked color imaging improves the visibility of colorectal polyps: a video study. Endosc Int Open. 2017;5:E518–E525.

    Article  Google Scholar 

  15. 15.

    Dohi O, Yagi N, Onozawa Y, et al. Linked color imaging improves endoscopic diagnosis of active Helicobacter pylori infection. Endosc Int Open. 2016;4:E800–E805.

    Article  Google Scholar 

  16. 16.

    Suzuki T, Hara T, Kitagawa Y, et al. Linked-color imaging improves endoscopic visibility of colorectal nongranular flat lesions. Gastrointest Endosc. 2017;86:692–697.

    Article  Google Scholar 

  17. 17.

    Sano Y, Tanaka S, Kudo SE, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016;28:526–533.

    Article  Google Scholar 

  18. 18.

    Participants in the Paris workshop. The Paris endoscopic classification of superficial neoplastic lesions: Esophagus, stomach, and colon-November 30 to December 1. Gastrointest Endosc. 2002;58:S3–S43.

    Article  Google Scholar 

  19. 19.

    Mokrzycki WS, Tatol M. Color difference Delta E—A survey. Machine Graphics and Vision. Warsaw, Poland: Faculty of Applied Informatics and Mathematics 2012.

  20. 20.

    Yoshida N, Naito Y, Murakami T, et al. Safety and efficacy of a same-day low-volume 1 L PEG bowel preparation in colonoscopy for the elderly people and people with renal dysfunction. Dig Dis Sci. 2016;61:3229–3235.

    Article  Google Scholar 

  21. 21.

    Hamilton SR, Aaltonen LA, editors. World Health Organization classification of tumors. Pathology and genetics of tumours of the digestive system. Lyon, France: IARC Press, 2010; 104–109.

  22. 22.

    Yoshida N, Naito Y, Yasuda R, et al. Linked color imaging improves the visibility of various featured colorectal polyps in an endoscopist’s visibility and color difference value. Int J Colorectal Dis. 2017;32:1253–1260.

    Article  Google Scholar 

  23. 23.

    Fujimoto D, Muguruma N, Okamoto K, et al. Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps. Endosc Int Open. 2018;06:E322–E334.

    Article  Google Scholar 

  24. 24.

    Min M, Deng P, Zhang W, et al. Comparison of linked color imaging and white-light colonoscopy for detection of colorectal polyps: a multicenter, randomized, crossover trial. Gastrointest Endosc. 2017;86:724–730.

    Article  Google Scholar 

  25. 25.

    Paggi S, Mogavero G, Amato A, et al. Linked color imaging reduces the miss rate of neoplastic lesions in the right colon: a randomized tandem colonoscopy study. Endoscopy. 2018;50:396–402.

    Article  Google Scholar 

  26. 26.

    Yoshida N, Inada Y, Yasuda R, et al. Additional thirty seconds observation with linked color imaging improves detection of missed polyps in the right-sided colon. Gastro Res Pract. 2018;2018:8798405.

    Google Scholar 

  27. 27.

    Oliveira Dos Santos CE, Malaman D, Pereira-Lima JC, et al. Impact of linked-color imaging on colorectal adenoma detection. Gastrointest Endosc 2019 Jul 11. [Epub ahead of print].

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Acknowledgments

We thank Dr. Kewin Tien Ho Siah, Dr. Rafiz Abdul Rani, and all members of the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, for helping with this study.

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Correspondence to Naohisa Yoshida.

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Conflict of interest

This study was performed by a research fund from Fujifilm (J162001222). Yoshito Itoh is affiliation with a donation-funded department from FUJIFILM Medical Co. Ltd. Naohisa Yoshida received a research grant from Fujifilm Co. The other authors have no conflicts of interest to declare.

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Three movies about white light imaging, linked color imaging, and blue laser imaging-bright for a non-polypoid lesion 18 mm, adenoma on the transverse colon (Figure 3a–3c) (MP4 21788 kb)

Three normal-speed movies and three 1.5 times faster movies about white light imaging, linked color imaging, and blue laser imaging for a polypoid lesion 5 mm, adenoma on the sigmoid colon (MP4 39774 kb)

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Yoshida, N., Hisabe, T., Ikematsu, H. et al. Comparison Between Linked Color Imaging and Blue Laser Imaging for Improving the Visibility of Flat Colorectal Polyps: A Multicenter Pilot Study. Dig Dis Sci 65, 2054–2062 (2020). https://doi.org/10.1007/s10620-019-05930-x

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Keywords

  • Colonoscopy
  • LASER
  • Colonic polyps
  • Linked color imaging
  • Blue laser imaging