Endoscopy 2025; 57(S 02): S111
DOI: 10.1055/s-0045-1805313
Abstracts | ESGE Days 2025
Oral presentation
Screening and Surveillance of Gastric Neoplasia 04/04/2025, 14:00 – 15:00 Room 122+123

Linked Color Imaging and Blue Laser Imaging have increased sensitivity in detecting atrophic gastritis

Authors

  • A Schmal

    1   Serviço de Gastrenterologia e Hepatologia – Hospital de Santa Maria, Lisboa, Portugal

  • R Cruz

    2   Gulbekian Institute for Molecular Medicine, Avenida Porfessor Egaz Moniz, Lisbon, Portugal, Lisbon, Portugal, Portugal
    3   Departamento de Anatomia Patológica – Hospital de Santa Maria, Avenida Professor Egas Moniz, Lisbon, Portugal
    4   Instituto de Histologia e Biologia do Desenvolvimento, Faculdade de Medicina de Lisboa, Lisbon, Portugal
    5   Instituto de Anatomia Patológica – Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal

  • F Capinha

    6   Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal

  • F Faustino

    1   Serviço de Gastrenterologia e Hepatologia – Hospital de Santa Maria, Lisboa, Portugal

  • F Rodrigues

    7   Hospital Universitário Pedro Ernesto – Universidade Estadual do Rio de Janeiro, Rio de Janeiro, State of Rio de Janeiro, Brazil

  • J Silva

    8   Hospital Lusíadas, Lisbon, Portugal

  • A T Carvalho

    9   Hospital Universitário Pedro Ernesto – Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil

  • H Souza

    10   Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

  • L Carrilho-Ribeiro

    11   Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal
    12   Clínica Universitária de Gastrenterologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal

  • L A Correa

    13   Serviço de Gastrenterologia e Hepatologia – Hospital de Santa Maria, Lisbon, Portugal, Portugal

  • C Noronha Ferreira

    14   Centro Hospital e Universitário de Lisboa Norte, Lisbon, Portugal
    12   Clínica Universitária de Gastrenterologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
    15   Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Aims Data on Blue Light Imaging (BLI) and Linked Color Imaging (LCI) for diagnosing atrophic gastritis (AG) is limited. We aimed to evaluate the diagnostic accuracy (DA) of LCI and BLI without magnification in detecting AG.

Methods Prospective, single-centre study in patients≥18y undergoing upper gastrointestinal endoscopy (UGIE) for clinical symptoms, IM follow-up, or GC screening. Of the 271 patients who were initially evaluated, 101 were excluded: No BLI/LCI 43 (16%), prior gastrectomy 28 (10%), intolerance 9 (3%), incomplete photo-documentation 5 (1.8%), pending histopathology 5 (1.8%), NBI 4 (1.5%) oesophageal stricture 1 (0.4%), UGIE contraindication 2 (0.7%), consent refusal 4 (1.5%), intolerance 9 (3%) and incomplete Sidney protocol 1 (0.4%). Standardized photo-documentation using white light imaging (WLI), LCI, and BLI. Kimura Takemoto (KT) classification of AG was used. Sydney protocol was used with histology as the gold standard with targeted biopsies from suspicious lesions. The chi-square test was used with significance at p<0.05.

Results The 170 patients had a median age of 59 (19-94) years, and 94 (55%) were female. Personal history of GC 4 (2.4%), 1º family history 29 (17%), past H. pylori infection 38 (22%) and smoking 64 (38%). Histological AG was detected in 66 (39%); WLI suspected AG in 44 (25%) cases, confirmed in 32(19%). LCI and BLI suspected AG in 63 (37%) and 66 (39%) of cases, confirmed in 46 (27%) and 59 (29%), respectively. BLI patterns of AG: spotty-9 (5%), cracked-29 (17%), mottled-13 (7%), undetermined-7 (4%), and mixed pattern-8 (5%) [1] [2] [3] [4]. Atrophic gastritis was classified according to KT classification: WLI: C1-9 (5%), C2-9 (5%), C3-3 (2%), O1-7 (4%), O2-3 (2%), O3-13 (8%); LCI: C1-18 (11%), C2-15 (9%), C3-6 (3%), O1-5 (3%), O2-7 (4%), O3-12 (7%); BLI: C1-27 (16%), C2-16 (9%), C3-3 (2%), O1-5 (3%), O2-7 (4%), O38 (5%). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for AG detection: WLI (48%, 89%, 73%, 73%, 73%), LCI (70%, 84%, 73%, 81%, 78%) and BLI (76%, 85%, 77%, 85%, 82%).

Conclusions BLI and LCI increase the detection of AG compared to WLI.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Nishikawa Y, Ikeda Y, Murakami H, Hori SI, Hino K, Sasaki C. et al. Classification of atrophic mucosal patterns on Blue LASER Imaging for endoscopic diagnosis of Helicobacter pylori-related gastritis: A retrospective, observational study PLoS One. 2018 13 (03).
    PubMed
  • 2 Kotelevets SM, Chekh SA, Chekh SA, Chukov SZ.. Updated Kimura-Takemoto classification of atrophic gastritis. World J Clin Cases 2021; 9 (13): 3014-23
    CrossrefPubMedSearch in Google Scholar
  • 3 Weigt J, Malfertheiner P, Canbay A, Haybaeck J, Bird-Lieberman E, Link A.. Blue Light Imaging and Linked Color Imaging for the Characterization of Mucosal Changes in Chronic Gastritis: A Clinicians View and Brief Technical Report. Digestive Diseases 2020; 38 (01): 9-14
    CrossrefPubMedSearch in Google Scholar
  • 4 Quach DT, Hiyama T.. Assessment of endoscopic gastric atrophy according to the kimura-takemoto classification and its potential application idaily practice. Vol. 52, Clinical Endoscopy. Korean Society of Gastrointestinal Endoscopy 2019; p 321-7
    PubMedSearch in Google Scholar