Yamamoto S¹, Shibano T¹, Sogabe M¹, Negishi H¹, Mitsuda S¹, Endo S¹

Respirol Case Rep. 2019 Feb 14;7(3):

Abstract:We report two cases of the comparison of diagnosis made with linked color imaging (LCI) and conventional white-light imaging (WLI) on the same patients. In case 1, a 75-year-old man in whom right upper lobectomy with mediastinal lymph node dissection was performed due to lung cancer had signs of bronchitis on postoperative day 8. The LCI demonstrated slight inflammatory changes that were not detectable with the conventional WLI on the tracheal wall. In case 2, in a 61-year-old woman who was diagnosed with adenoid cystic carcinoma, the bronchial wall was checked to confirm the extent of the tumour. The submucosal vascularity and tumour margin on the bronchial mucosa were better visible on LCI than on WLI. We could easily detect the mucosal inflammatory lesion and the malignant lesion with LCI in comparison with conventional WLI. Both mucosal inflammatory and malignant lesions were better visible with LCI in comparison to WLI.

1 Department of General Thoracic Surgery, Jichi Medical University, Shimotsuke, Japan.

Min M¹, Su S¹, He W², Bi Y¹, Ma Z², Liu Y².

Sci Rep. 2019 Feb 27;9(1):2881. doi: 10.1038/s41598-019-39416-7.

We developed a computer-aided diagnosis (CAD) system based on linked color imaging (LCI) images to predict the histological results of polyps by analyzing the colors of the lesions. A total of 139 images of adenomatous polyps and 69 images of non-adenomatous polyps obtained from our hospital were collected and used to train the CAD system. A test set of LCI images, including both adenomatous and non-adenomatous polyps, was prospectively collected from patients who underwent colonoscopies between Oct and Dec 2017; this test set was used to assess the diagnostic abilities of the CAD system compared to those of human endoscopists (two experts and two novices). The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of this novel CAD system for the training set were 87.0%, 87.1%, 87.0%, 93.1%, and 76.9%, respectively. The test set included 115 adenomatous polyps and 66 non-adenomatous polyps that were prospectively collected. The CAD system identified adenomatous or non-adenomatous polyps in the test set with an accuracy of 78.4%, a sensitivity of 83.3%, a specificity of 70.1%, a PPV of 82.6%, and an NPV of 71.2%. The accuracy of the CAD system was comparable to that of the expert endoscopists (78.4% vs 79.6%; p = 0.517). In addition, the diagnostic accuracy of the novices was significantly lower to the performance of the experts (70.7% vs 79.6%; p = 0.018). A novel CAD system based on LCI could be a rapid and powerful decision-making tool for endoscopists.

1 Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences Beijing, 100071, China
2 Pattern Recognition and Intelligent System Laboratory, School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Beijing, 100876, China. Min Min and Song Su contributed equally.

Yamamoto H¹, Shinozaki S², Hayashi Y¹, Miura Y¹, Khurelbaatar T¹, Osawa H¹, Lefor AK³.

Clin Endosc. 2019 Jan 10. doi: 10.5946/ce.2018.189. [Epub ahead of print]

Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques. However, the detection of small, flat-shaped, or faded color lesions remains difficult. Linked color imaging, a novel multi-light technology, facilitates the recognition of minor differences in tissue by enhancing the color contrast between early colorectal neoplasms and surrounding normal mucosa in a bright field of view. The most striking feature of linked color imaging is its ability to display the color of early neoplastic lesions as distinct from inflammatory changes, both of which have similar “redness” when viewed using white light imaging. To increase the detection rate of neoplasms, linked color imaging should be used from the outset for endoscopic observation. Early detection of superficial colorectal tumors can result in decreased mortality from colorectal cancer and maintain a good quality of life for patients.

1 Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke
2 Shinozaki Medical Clinic, Utsunomiya,
3 Department of Surgery, Jichi Medical University, Shimotsuke, Japan

Ono S¹, Ono Y², Sakamoto N³.

Dig Endosc. 2019 Jan 28. doi: 10.1111/den.13362. [Epub ahead of print]

Recently, there have been some reports that image-enhanced endoscopy (IEE) may be useful for detection of gastric intestinal metaplasia (GIM) (1, 2). Linked color imaging (LCI) enables noninvasive detection of GIM as a lavender color, which is called lavender color sign (LCS) (3). Spraying l-menthol directly onto the gastric antral mucosa is useful for anti-peristalsis. As a secondary effect of spraying l-menthol, Mori et al. reported annular-reticular-like mucosal changes that were mucosal morphologic changes. This article is protected by copyright. All rights reserved.

1 Department of Gastroenterology, Hokkaido University Hospital, Sapporo
2 Department of Gastroenterology, Sapporo City Hospital, Sapporo
3 Department of Gastroenterology and Hepatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.