Linked color imaging improves the diagnostic accuracy of eosinophilic esophagitis

Abe, Yasuhiko; Sasaki, Yu; Yagi, Makoto; Mizumoto, Naoko; Onozato, Yusuke; Kon, Takashi; Shoji, Masakuni; Sakuta, Kazuhiro; Sakai, Takayuki; Umehara, Matsuki; Ito, Minami; Nakamura, Shuhei; Tsuchida, Hiroyuki; Ueno, Yoshiyuki

doi:10.1002/deo2.146

Cited by 6 publications

(6 citation statements)

References 45 publications

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“…The optimal cutoff value for the ERERS score to predict EoE has not been determined. Some reports showed that an EREFS ≥ 2 can predict EoE with relatively high sensitivity and specificity [ 38 , 48 ], while others suggested that it was not sufficient to discriminate between EoE and non-EoE, due to low specificity against high sensitivity [ 49 ]. This discrepancy may be due to differences in the endoscopic severity of the EoE group enrolled in each study, and the clinical profiles of the non-EoE comparative groups.…”

Section: Eoe Endoscopic Reference Score (Erefs)mentioning

confidence: 99%

“…In a more recent Japanese study, interobserver and intraobserver agreement have been reported to increase to 0.60 and 0.74 for WLI, respectively. This might reflect an increasing awareness of EoE [ 48 ]. The comparison between original EREFS and expanded EREFS by Ma et al does not show a significant difference in the diagnostic agreement regarding each endoscopic finding [ 36 ].…”

Section: Diagnostic Agreement Of Endoscopic Findings and Diagnosismentioning

confidence: 99%

“…We also recently showed that LCI in addition to WLI improved the diagnostic accuracy of the individual endoscopic findings, especially furrows, rings, and stricture, and the overall diagnosis of EoE with “moderate” to “substantial” consistency compared with WLI alone. The improvement in diagnostic accuracy by LCI was more remarkable in cases with milder endoscopic findings than in those with more prominent findings, and in endoscopists with less EoE experience than in those with more EoE experience [ 48 ]. It is speculated that LCI potentially improves the visibility of the EoE by increasing the contrast between red and white areas, and illuminating more brightly up to the more distal esophagus ( Figure 6 ).…”

Section: Diagnostic Agreement Of Endoscopic Findings and Diagnosismentioning

confidence: 99%

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Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

et al. 2022

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Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease, characterized by esophageal dysfunction and intense eosinophil infiltration localized in the esophagus. In recent decades, EoE has become a growing concern as a major cause of dysphagia and food impaction in adolescents and adults. EoE is a clinicopathological disease for which the histological demonstration of esophageal eosinophilia is essential for diagnosis. Therefore, the recognition of the characteristic endoscopic features with subsequent biopsy are critical for early definitive diagnosis and treatment, in order to prevent complications. Accumulating reports have revealed that EoE has several non-specific characteristic endoscopic findings, such as rings, furrows, white exudates, stricture/narrowing, edema, and crepe-paper esophagus. These findings were recently unified under the EoE endoscopic reference score (EREFS), which has been widely used as an objective, standard measurement for endoscopic EoE assessment. However, the diagnostic consistency of those findings among endoscopists is still inadequate, leading to underdiagnosis or misdiagnosis. Some endoscopic findings suggestive of EoE, such as multiple polypoid lesions, caterpillar sign, ankylosaurus back sign, and tug sign/pull sign, will aid the diagnosis. In addition, image-enhanced endoscopy represented by narrow band imaging, endocytoscopy, and artificial intelligence are expected to render endoscopic diagnosis more efficient and less invasive. This review focuses on suggestions for endoscopic assessment and biopsy, including recent advances in optical technology which may improve the diagnosis of EoE.

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Section: Eoe Endoscopic Reference Score (Erefs)mentioning

confidence: 99%

Section: Diagnostic Agreement Of Endoscopic Findings and Diagnosismentioning

confidence: 99%

Section: Diagnostic Agreement Of Endoscopic Findings and Diagnosismentioning

confidence: 99%

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Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

et al. 2022

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“…This technology is based on the combination of four types of light as source emitters: blue-violet, blue, green, and red. LCI is a recent development (Fujifilm Corporate) in imaging technology created by a short-wavelength narrowband laser light in combination with a white laser light, enabling a brighter light in distant areas with a higher contrast between white and red spots [ 6 ]. BLI and LCI are two of the observation modes of the four-LED multi-light technology that allows enhanced visualization of hemoglobin by, respectively, intensifying the blue or red light spectrum, improving delineation and detection [ 7 , 8 , 9 ].…”

Section: Advanced Endoscopic Imaging Technologies For Detection and M...mentioning

confidence: 99%

Advanced Imaging in Gastrointestinal Endoscopy: A Literature Review of the Current State of the Art

Sinonquel¹,

Vermeire²,

Maes³

et al. 2022

GE Port J Gastroenterol

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Background and Aims: Gastrointestinal (GI) endoscopy has known a great evolution in the last decades. Imaging techniques evolved from imaging with only standard white light endoscopes toward high-definition resolution endoscopes and the use of multiple color enhancement techniques, over to automated endoscopic assessment systems based on artificial intelligence. This narrative literature review aimed to provide a detailed overview on the latest evolutions within the field of advanced GI endoscopy, mainly focusing on the screening, diagnosis, and surveillance of common upper and lower GI pathology. Methods: This review comprises only literature about screening, diagnosis, and surveillance strategies using advanced endoscopic imaging techniques published in (inter)national peer-reviewed journals and written in English. Studies with only adult patients included were selected. A search was performed using MESH terms: dye-based chromoendoscopy, virtual chromoendoscopy, video enhancement technique, upper GI tract, lower GI tract, Barrett’s esophagus, esophageal squamous cell carcinoma, gastric cancer, colorectal polyps, inflammatory bowel disease, artificial intelligence. This review does not elaborate on the therapeutic application or impact of advanced GI endoscopy. Conclusions: Focusing on current and future applications and evolutions in the field of both upper and lower GI advanced endoscopy, this overview is a practical but detailed projection of the latest developments. Within this review, an active leap toward artificial intelligence and its recent developments in GI endoscopy was made. Additionally, the literature is weighted against the current international guidelines and assessed for its potential positive future impact.

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“…Prior reports have found that LCI increases color differences and visibility in gastric cancer, colorectal neoplasia, and duodenal tumors [10][11][12][13][14]. Recently, LCI has also been found to be beneficial in the endoscopic detection of both neoplastic lesions and inflammatory lesions such as reflux esophagitis and eosinophilic esophagitis [15,16].…”

Section: Introductionmentioning

confidence: 99%

Linked Color Imaging of Barrett’s Esophageal Adenocarcinoma: Effects on Visibility

Saito,

Koike,

Ohara

et al. 2024

Gastroenterology Insights

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Since linked color imaging (LCI) has been reported to increase the color differences in Barrett’s esophageal adenocarcinoma (BA) compared to white light imaging (WLI), a comparison of the visibility scores of various imaging techniques for BA is warranted to determine best practice standards. This study is to clarify the role of LCI, blue light imaging (BLI), and WLI in the evaluation of BA. A group of 19 endoscopists, comprised of 6 experts and 13 trainees, evaluated the visibility of WLI, BLI, and LCI images in 21 superficial BA cases. Visibility scores were compared between WLI, BLI, and LCI. Visibility scores were also evaluated for lesion morphology, background Barrett’s mucosa, and circumferential location. The visibility scores of experts and trainees were analyzed for comparison. The visibility scores of LCI and BLI were 3.83 and 3.31, respectively, compared to three points for WLI. The visibility of LCI was better than that of WLI regardless of lesion morphology, color, background Barrett’s mucosa, and circumferential location. The LCI improved visibility in BA more than the WLI for both experts and trainees. LCI improved the visibility of BA independent of lesion morphology, color, background Barrett’s mucosa, circumferential location, and the endoscopist’s experience.

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Linked color imaging improves the diagnostic accuracy of eosinophilic esophagitis

Cited by 6 publications

References 45 publications

Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances

Advanced Imaging in Gastrointestinal Endoscopy: A Literature Review of the Current State of the Art

Linked Color Imaging of Barrett’s Esophageal Adenocarcinoma: Effects on Visibility

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