Linked color imaging can improve the visibility of superficial non-ampullary duodenal epithelial tumors

Kenichiro Okimoto1, Daisuke Maruoka1, Tomoaki Matsumura1, Mamoru Tokunaga1, Tatsuya Kaneko1, Hirotaka Oura1, Naoki Akizue1, Yuki Ohta1, Keiko Saito1, Makoto Arai1, Jun Kato1, Naoya Kato1

Scientific Reports volume 10, Article number: 20667 (2020)

The current study aimed to evaluate the efficacy of linked color imaging (LCI) in improving the visibility of superficial non-ampullary duodenal epithelial tumors (SNADETs). We prospectively evaluated 44 consecutive patients diagnosed with SNADETs. Three trainees and three experts assessed the visibility scores of white light imaging (WLI), LCI, and blue laser imaging-bright (BLI-b) for SNADETs, which ranged from 1 (not detectable without repeated cautious examination) to 4 (excellent visibility). In addition, the L* a* b* color values and color differences (ΔE) were evaluated using the CIELAB color space system. For SNADETs, the visibility scores of LCI (3.53 ± 0.59) were significantly higher than those of WLI and BLI-b (2.66 ± 0.79 and 3.41 ± 0.64, respectively). The color differences (ΔE) between SNADETs and the adjacent normal duodenal mucosa in LCI mode (19.09 ± 8.33) were significantly higher than those in WLI and BLI-b modes (8.67 ± 4.81 and 12.92 ± 7.95, respectively). In addition, the visibility score of SNADETs and the color differences in LCI mode were significantly higher than those in WLI and BLI-b modes regardless of the presence of milk white mucosa (MWM). LCI has potential benefits, and it is considered a promising clinical modality that can increase the visibility of SNADETs regardless of the presence of MWM.

1 Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1‐8‐1, Chiba City 260‐8670, Japan