Linked color imagingはsessile serrated adenoma/polypsの検出率を向上させる
藤本, 大策 徳島大学大学院医科学教育部（医学専攻）
六車, 直樹 Tokushima University KAKEN研究者をさがす
岡本, 耕一 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
藤野, 泰輝 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Kagemoto, Kaizo Tokushima University
岡田, 泰行 Tokushima University 徳島大学 教育研究者総覧
Takaoka, Yoshifumi Tokushima University
三井, 康裕 Tokushima University 徳島大学 教育研究者総覧
北村, 晋志 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
木村, 哲夫 Tokushima University KAKEN研究者をさがす
宮本, 弘志 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
坂東, 良美 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Sonoda, Tomoko Sapporo Medical University
高山, 哲治 Tokushima University 徳島大学 教育研究者総覧 KAKEN研究者をさがす
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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