Linked color imagingはsessile serrated adenoma/polypsの検出率を向上させる
Fujimoto, Daisaku Tokushima University
Okamoto, Koichi Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Fujino, Yasuteru Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Kagemoto, Kaizo Tokushima University
Okada, Yasuyuki Tokushima University Tokushima University Educator and Researcher Directory
Takaoka, Yoshifumi Tokushima University
Mitsui, Yasuhiro Tokushima University Tokushima University Educator and Researcher Directory
Kitamura, Shinji Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Miyamoto, Hiroshi Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Bando, Yoshimi Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Sonoda, Tomoko Sapporo Medical University
Thesis or Dissertation
Background and study aims Although new image-enhanced endoscopy (IEE) technologies such as blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI) have been developed, their utility for the detection of sessile serrated adenoma/polyps (SSA/Ps) is still unclear. This study aimed to evaluate the utility of BLI, BLI-bright, and LCI for SSA/P detection in still image examinations and in a prospective randomized controlled trial (RCT).
Patients and methods A group of 6 expert and non-expert endoscopists read 200 endoscopic still images containing SSA/P lesions using white light image (WLI), BLI, BLI-bright, and LCI. Color differences were calculated using the color space method. A prospective RCT of tandem colonoscopy with WLI and LCI was performed. Patients with SSA/P and those with a history of SSA/P that had been endoscopically removed were enrolled and randomly allocated to WLI-LCI or LCI-WLI groups. Additional endoscopic detection rates for SSA/P were compared between the 2 groups.
Results LCI showed the highest SSA/P detection rate among the 4 modes for both expert and non-expert endoscopists. The detection rate with LCI for the 6 expert endoscopists (mean 98.3 ± standard deviation 2.0%) was significantly higher than that with WLI (86.7 ± 6.0 %, P < 0.01). Likewise, the detection rate with LCI for the 6 non-expert endoscopists (92.3 ± 2.9 %) was significantly higher than that with WLI (72.7±11.5%, P < 0.01). The color difference of SSA/P with LCI was the highest among the 4 modes, and was significantly higher than with WLI (median 15.9, (interquartile range 13.7 – 20.6) vs. 10.2, (7.6 – 14.2); P < 0.0001). In the RCT, a total of 44 patients (WLI-LCI 22 vs. LCI-WLI 22) underwent colonoscopy. The additional detection rate for SSA/P in the second inspection in the WLI-LCI group (21.6 %, 8/37) was significantly higher than in the LCI-WLI group (3.2 %, 1/31; P = 0.02). The small, flat, non-mucus and isochromatic SSA/Ps in the transverse colon were detected more frequently in the second inspection with LCI.
Conclusions LCI was the most sensitive mode for SSA/P detection among WLI, BLI, BLI-bright, and LCI in the still image examinations. Our RCT strongly suggests that LCI is superior to conventional WLI for SSA/P detection during colonoscopy. UMIN000017599.
Endoscopy International Open
© Georg Thieme Verlag KG 2018
This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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k3133_abstract_review.pdf 322 KB
k3133_fulltext.pdf 1.6 MB
|MEXT report number||
Doctor of Medical Science