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ID 111442
タイトル別表記
Linked color imagingはsessile serrated adenoma/polypsの検出率を向上させる
著者
藤本, 大策 徳島大学大学院医科学教育部(医学専攻)
Kagemoto, Kaizo Tokushima University
Okada, Yasuyuki Tokushima University
Takaoka, Yoshifumi Tokushima University
Sonoda, Tomoko Sapporo Medical University
キーワード
SSA/P
LCI
Colorectal cancer
IEE
資料タイプ
学位論文
抄録
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.
掲載誌名
Endoscopy International Open
ISSN
23643722
21969736
出版者
Thieme
6
3
開始ページ
E322
終了ページ
E334
発行日
2018-03-07
備考
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。
権利情報
© 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
出版社版DOI
出版社版URL
フルテキストファイル
言語
jpn
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3133号
学位記番号
甲医第1367号
学位授与年月日
2018-03-23
学位名
博士(医学)
学位授与機関
徳島大学
部局
医学系
病院