Koki Nakamura1, Yuji Urabe2, Shiro Oka3, Naoko Nagasaki3, Naoki Yorita3, Kosaku Hata3, Kazuhiko Masuda3, Mio Kurihara3, Takahiro Kotachi1, Tomoyuki Boda1, Shinji Tanaka1, Kazuaki Chayama3
Esophagus. 2020 May 23. doi: 10.1007/s10388-020-00749-2. Online ahead of print.
Background and aims: Linked color imaging (LCI) improved the visibility of gastric cancer and colorectal flat lesions. This study aimed to investigate the usefulness of LCI in detecting superficial esophageal squamous cell carcinomas (SESCC).
Methods: We enrolled 37 consecutive SESCC patients (46 SESCCs) diagnosed using LCI and blue laser imaging bright mode (BLI-BRT) and treated in Hiroshima University Hospital between April 2018 and November 2018. Eight professional endoscopists compared images obtained on non-magnifying BLI-BRT and LCI versus conventional white light imaging (WLI). Identification and boundary diagnosis of SESCC with LCI and BLI-BRT were compared with WLI. Changes in lesion visibility were clarified. Interobserver agreement was assessed. Clinicopathological features of lesion that influence visibility with LCI were assessed.
Results: In LCI, 37% (17/46) of cases had improved visibility and 63% (29/46) had unchanged visibility (interobserver agreement = 0.74). Among cases with multiple lugol voiding lesions (LVLs), ΔE between the lesion and background mucosa was significantly higher in LCI than in WLI (20.8 ± 7.9 vs 9.2 ± 6.1, P < 0.05). No significant differences were found in tumor size, morphological type, color, depth, and smoking or drinking history. However, multiple LVLs were significantly higher among cases with improved versus unchanged visibility. On BLI-BRT, 39% (18/46) of cases had improved visibility and 61% (28/46) had unchanged visibility (interobserver agreement = 0.60).
Conclusion: Almost the same as BLI-BRT, LCI improves SESCC visibility compared with WLI. This is useful for cases with multiple LVLs. In cases without background coloration (BGC), LCI may make SESCC more visible than BLI-BRT.
1 Department of Endoscopy, Hiroshima University Hospital,Hiroshima, Japan
2 Department of Regeneration and Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku,Hiroshima 734-8551, Japan
3 Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan