Takeda T¹, Nagahara A², Ishizuka K¹, Okubo S¹, Haga K¹, Suzuki M¹, Nakajima A¹, Komori H¹, Akazawa Y¹, Izumi K¹, Matsumoto K¹, Ueyama H¹, Shimada Y¹, Matsumoto K¹, Asaoka D¹, Shibuya T¹, Sakamoto N¹, Osada T¹, Hojo M¹, Nojiri S³, Watanabe S¹.

Digestion. 2018 Jan 10;97(2):183-194. doi: 10.1159/000485459. [Epub ahead of print]

Background/Aims: To evaluate the usefulness of linked color imaging (LCI) and blue LASER imaging (BLI) in Barrett’s esophagus (BE) compared with white light imaging (WLI).

Methods: Five expert and trainee endoscopists compared WLI, LCI, and BLI images obtained from 63 patients with short-segment BE. Physicians assessed visibility as follows: 5 (improved), 4 (somewhat improved), 3 (equivalent), 2 (somewhat decreased), and one (decreased). Scores were evaluated to assess visibility. The inter- and intra-rater reliability (intra-class correlation coefficient) of image assessments were also evaluated. Images were objectively evaluated based on L* a* b* color values and color differences (ΔE*) in a CIELAB color space system.

Results: Improved visibility compared with WLI was achieved for LCI: 44.4%, BLI: 0% for all endoscopists; LCI: 55.6%, BLI: 1.6% for trainees; and LCI: 47.6%, BLI: 0% for experts. The visibility score of trainees compared with experts was significantly higher for LCI (p = 0.02). Intra- and inter-rater reliability ratings for LCI compared with WLI were “moderate” for trainees, and “moderate-substantial” for experts. The ΔE* revealed statistically significant differences between WLI and LCI.

Conclusion: LCI improved the visibility of short-segment BE compared with WLI, especially for trainees, when evaluated both subjectively and objectively.

^{1 Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
2 Department of Gastroenterology, Juntendo Sizuoka Hospital, Sizuoka, Japan.
3 Department of Medical Technology Innovation Center, Juntendo University School of Medicine, Tokyo, Japan.}