CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(02): E164-E170
DOI: 10.1055/a-0733-7086
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Linked color imaging improves the endoscopic visibility of gastric mucosal cancers

Yoshiyasu Kitagawa
1  Endoscopy Division, Chiba Cancer Center, Chiba, Japan
,
Takuto Suzuki
1  Endoscopy Division, Chiba Cancer Center, Chiba, Japan
,
Taro Hara
2  Hara Clinic, Chiba, Japan
,
Rino Nankinzan
1  Endoscopy Division, Chiba Cancer Center, Chiba, Japan
,
Hideyuki Takashiro
1  Endoscopy Division, Chiba Cancer Center, Chiba, Japan
,
Osamu Sugita
1  Endoscopy Division, Chiba Cancer Center, Chiba, Japan
,
Hiroshi Imazeki
3  Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
,
Taketo Yamaguchi
3  Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
› Author Affiliations
Further Information

Publication History

submitted 25 January 2018

accepted after revision 11 June 2018

Publication Date:
18 January 2019 (online)

  

Abstract

Background and study aims As a newly developed endoscopy technique, linked color imaging (LCI) provides very bright images with enhanced color tones. With the objective of improving the detection rate of gastric mucosal cancers, which are often difficult to detect, we examined the utility of LCI from the viewpoint of visibility.

Patients and methods The current study used 100 consecutive gastric mucosal cancers ≤ 20 mm in diameter. For each lesion, we selected one endoscopic image acquired by white-light imaging (WLI), blue-laser imaging (BLI) -bright, and LCI modes. Four endoscopists interpreted the images; using a previously reported scale, we scored the visibility level on a scale of 1 – 4.

Results The mean (± SD) visibility scores were 2.54 ± 1.10 for WLI, 3.02 ± 1.07 for BLI-bright, and 3.28 ± 0.97 for LCI. The score was significantly higher for BLI-bright compared with WLI (P < .001) and again higher for LCI compared with BLI-bright (P < .001). For the experts, the scores for BLI-bright and LCI were similar, but both were significantly higher than the score for WLI. For the trainees, there was no significant difference between the WLI and BLI-bright scores, but LCI score was significantly higher than those for WLI and BLI-bright scores. With regard to clinical characteristics, LCI particularly enhanced visibility of normochromic, flat and depressed lesions, which had the lowest visibility scores of all three modalities compared with those of the other lesions.

Conclusion LCI increased visibility and may contribute to early detection of gastric mucosal cancers.