ID | 111442 |
Title Alternative | Linked color imagingはsessile serrated adenoma/polypsの検出率を向上させる
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Author |
Fujimoto, Daisaku
Tokushima University
Muguruma, Naoki
Tokushima University
Tokushima University Educator and Researcher Directory
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Okamoto, Koichi
Tokushima University
Tokushima University Educator and Researcher Directory
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Kagemoto, Kaizo
Tokushima University
Takaoka, Yoshifumi
Tokushima University
Miyamoto, Hiroshi
Tokushima University
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Bando, Yoshimi
Tokushima University
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Sonoda, Tomoko
Sapporo Medical University
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Keywords | SSA/P
LCI
Colorectal cancer
IEE
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Content Type |
Thesis or Dissertation
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Description | 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. |
Journal Title |
Endoscopy International Open
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ISSN | 23643722
21969736
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Publisher | Thieme
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Volume | 6
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Issue | 3
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Start Page | E322
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End Page | E334
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Published Date | 2018-03-07
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Remark | 内容要旨・審査要旨・論文本文の公開
本論文は,著者Daisaku Fujimotoの学位論文として提出され,学位審査・授与の対象となっている。 |
Rights | © 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/). |
EDB ID | |
DOI (Published Version) | |
URL ( Publisher's Version ) | |
FullText File | |
language |
jpn
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TextVersion |
ETD
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MEXT report number | 甲第3133号
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Diploma Number | 甲医第1367号
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Granted Date | 2018-03-23
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Degree Name |
Doctor of Medical Science
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Grantor |
Tokushima University
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departments |
Medical Sciences
University Hospital
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