Evaluation of the impact of linked color imaging for improving the visibility of colonic polyp.

Tanaka Y1, Inoue T1,2, Kakimoto K1, Nakazawa K1, Tawa H1, Hirata Y1, Okada T1, Nouda S1, Kawakami K1, Takeuchi T1, Egashira Y3, Higuchi K1.

Oncol Lett. 2019 Nov;18(5):5555-5560. doi: 10.3892/ol.2019.10917. Epub 2019 Sep 24.

Linked color imaging (LCI) is a novel endoscopic system used to increase color contrast. As LCI does not decrease luminal brightness, it may improve the detection of colonic neoplasms. However, the extent to which LCI improves the visibility of colonic polyps has not yet been determined. Between December 2016 and May 2017, patients who received total colonoscopy were consecutively recruited into this retrospective, single-center study. For each polyp identified, images obtained from white light (WL) imaging, blue laser imaging (BLI), and LCI of the same lesion and its surrounding mucosa were evaluated. The color differences (ΔE) between each lesion and its surrounding mucosa in non-magnified images were computed quantitatively using the CIELAB color space, which defines color perception according to colorimetric values, and compared among WL, BLI, LCI, and chromoendoscopy. The ΔE between the vessel and non-vessel areas in magnified images was also assessed. Of the 64 patients who were incorporated into this study, non-magnified and magnified (×80) images from 113 and 95 polyps, respectively, were assessed. The ΔE was intensified by LCI and chromoendoscopy compared with WL and BLI. The ΔE of neoplastic lesions was also intensified by LCI. In magnified images, BLI and LCI significantly increased the ΔE between the vessel and non-vessel areas compared with WL. Luminal brightness, indicated by L*, was not impaired by LCI; however, was reduced by BLI compared with WL and LCI. These results suggest that LCI enhanced the detection of colonic neoplasms without impairing luminal brightness. We propose the routine use of LCI for colonic polyp detection and BLI for magnifying observations of colonic polyps detected by LCI.

1 Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka 569-8686;
2 Department of Gastroenterology, Inoue Gastroenterology and Endoscopy Clinic, Osaka 595-0072;
3 Department of Pathology, Osaka Medical College, Takatsuki, Osaka 569-8686, Japan