Additional value of linked color imaging in colonoscopy: a retrospective study.

Sakamoto T1, Tomizawa 1,2, Cho H1, Takamaru H1, Sekiguchi M1, Yamada M1,3, Matsuda T1, Murakami Y4, Saito Y1.

Endosc Int Open. 2019 Nov;7(11):E1448-E1454. doi: 10.1055/a-0982-2904. Epub 2019 Oct 22.

Background and study aims: Linked color imaging (LCI), a newly developed optical modality, enhances mucosal surface contrast. We aimed to evaluate the efficacy and feasibility of insertion-phase LCI in terms of additional benefit of colorectal polyp detection over that obtained with white light imaging (WLI).

Patients and methods: We consecutively enrolled eligible patients from November 2017 to June 2018. During colonoscopy, LCI or WLI was alternatively applied on scope insertion and LCI was applied on scope withdrawal. Patients were divided into two groups according to the protocolized difference of imaging modality used in the scope insertion phase (LCI and WLI groups). Group differences in clinical outcomes were evaluated.

Results: A total of 138 patients were enrolled in this study, with equal numbers of patients assigned to the LCI and WLI groups. Most of the lesions located in the proximal colon were detected during the withdrawal phase, without a difference in proportions between the two groups. However, in the LCI group, eight of 49 lesions (16 %) located in the sigmoid and rectosigmoid colon were only detected during the insertion phase, and no such lesions (0 %) were detected during the insertion phase in the WLI group ( P  = 0.045).

Conclusions: This study showed the efficacy and feasibility of LCI in improving colorectal polyp detection in the sigmoid colon, especially during insertion. Further studies are warranted to validate the results of our single-center study.

1 Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
2 Gastroenterology, Harborview Medical Center, Seattle, Washington, United States
3 Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo, Japan
4 Department of Medical Statistics, Toho University, Tokyo, Japan