Disclosures: The authors report no relevant financial disclosures.
April 08, 2021
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Linked color imaging may improve adenoma detection in endoscopy

Disclosures: The authors report no relevant financial disclosures.
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Endoscopy with linked color imaging may help improve adenoma detection, particularly among endoscopists who normally have lower adenoma detection rates, according to study results.

“Linked color imaging [LCI] is a new equipment-based image-enhanced endoscopy [eIEE] designed to enhance slight color differences,” Takeshi Yamamura, MD, PhD, from the department of gastroenterology and hepatology at Nagoya University Graduate School of Medicine in Japan, and colleagues wrote. “LCI enhances the color separation of red blood vessels and white pits, allowing similar visualization to conventional white light imaging [WLI]. Furthermore, LCI is brighter than blue laser imaging [BLI]-bright and is expected to enhance visibility to improve polyp detection.”

Researchers conducted a randomized, tandem trial to analyze the efficacy of LCI compared with WLI. They randomly assigned patients (n = 700) to two groups. In the first, patients underwent observation with LCI followed by WLI. In the second, patients underwent both observations with WLI.

The primary outcome of the study was ADR during the first observation. Investigators also assessed adenoma miss rate (AMR) and visibility score.

Yamamura and colleagues found that both groups had similar ADR (LCI, 69.6% vs. WLI, 63.2%), However, endoscopy with LCI helped improve average ADR among endoscopists with low detection rates (76%) compared with high-detectors (55.1%; P < .001).

Additionally, the total AMR in the LCI group (20.6%) was lower than in the WLI group (31.1%; P < .001). Specifically, the LCI group had lower AMR for diminutive adenomas (23.4% vs. 35.1%; P < .001) and non-polypoid lesions (25.6% vs. 37.9%; P < .001).

“We did not find a significant difference for ADR between the WLI and LCI groups,” the investigators wrote. “However, the LCI improved the ADR in lower detectors. Our data suggest that LCI makes a significant difference in AMR, particularly in detecting diminutive or non-polypoid adenomas, even for expert endoscopists with a high ADR.”

Yamamura and colleagues wrote that current research should help provide insight into future studies, particularly for trainees, high-risk patients and other head-to-head comparisons.