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

A Schmal; R Cruz; F Capinha; F Faustino; F Rodrigues; J Silva; A T Carvalho; H Souza; L Carrilho-Ribeiro; L A Correa; C Noronha Ferreira

doi:10.1055/s-0045-1805313

Endoscopy, Table of Contents

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

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

²Gulbekian Institute for Molecular Medicine, Avenida Porfessor Egaz Moniz, Lisbon, Portugal, Lisbon, Portugal, Portugal

³Departamento de Anatomia Patológica – Hospital de Santa Maria, Avenida Professor Egas Moniz, Lisbon, Portugal

⁴Instituto de Histologia e Biologia do Desenvolvimento, Faculdade de Medicina de Lisboa, Lisbon, Portugal

⁵Instituto de Anatomia Patológica – Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
F Capinha

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

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

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

⁸Hospital Lusíadas, Lisbon, Portugal
A T Carvalho

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

¹⁰Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
L Carrilho-Ribeiro

¹¹Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal

¹²Clínica Universitária de Gastrenterologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
L A Correa

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

¹⁴Centro Hospital e Universitário de Lisboa Norte, Lisbon, Portugal

¹²Clínica Universitária de Gastrenterologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal

¹⁵Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal

Abstract

Full Text

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.

References

References
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