Linked colour imaging benefits the endoscopic diagnosis of distal gastric diseases

Sun, Xiaotian; Bi, Yiliang; Dong, Tenghui; Min, Min; Shen, Wei; Xu, Yang; Liu, Yan

doi:10.1038/s41598-017-05847-3

Cited by 20 publications

(30 citation statements)

References 23 publications

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“…The sample size was calculated based on a probability of 0.8 and α error of 0.05. The actual expected sensitivity of LCI and WLE for diagnosing H. pylori was around 80 % and 45% according to our previous study and experience 10 12 . The required sample size was set to 250 patients.…”

Section: Methodsmentioning

confidence: 82%

Linked color imaging confers benefits in profiling H. pylori infection in the stomach

Sun

Nong

et al. 2019

Endosc Int Open

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Background and study aims There is a high prevalence of Helicobacter pylori infection. White light endoscopy (WLE) can be used for evaluating the mucosal lesions, but it does not have high diagnostic efficiency. Linked color imaging (LCI) is a newly developed endoscopic imaging technique. The aim of this study was to compare LCI with WLE in detecting and staging H. pylori infection in the stomach in a randomized controlled clinical trial. Patients and methods A total of 253 patients who had indications for gastroduodenoscopy were enrolled and randomized into Group A (n = 127), who underwent WLE followed by LCI, and Group B (n = 126), who underwent LCI followed by WLE. Clinical data were collected and the diagnostic accuracy of WLE and LCI was calculated and compared. Results The overall diagnostic accuracy of WLE and LCI for H. pylori infection was 31.5 % (n = 40) and 50.4 % (n = 64) in Group A (P = 0.001), and 36.5 % (n = 46) and 49.2 % (n = 62) in Group B (P = 0.029). In both groups, LCI had higher sensitivity, specificity, and Youden index scores than WLE. Four stages were defined in the course of H. pylori infection in the stomach. LCI staging results were more highly consistent with pathological staging than were WLE staging results (kappa value 0.772 vs. 0.516). The LCI observations were closely correlated with the pathology. Conclusion LCI had a higher diagnostic efficacy for H. pylori infection in the stomach. Endoscopic color features under LCI can help to stage and profile H. pylori-associated gastritis.

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Section: Methodsmentioning

confidence: 82%

Linked color imaging confers benefits in profiling H. pylori infection in the stomach

Sun

Nong

et al. 2019

Endosc Int Open

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“…Furthermore, Sun et al [21] established an LCI-based endoscopic model called color-microstructure-vessel criteria to extract color features, which allowed for predicting chronic nonatrophic gastritis, chronic atrophic gastritis, and gastric cancer. This is a creative idea and could be combined with RGB to improve the accuracy and efficiency of diagnosing gastric mucosal lesions and benefit target biopsy.…”

Section: Discussionmentioning

confidence: 99%

RGB Pixel Brightness Characteristics of Linked Color Imaging in Early Gastric Cancer: A Pilot Study

Sun

Zhao

2020

Gastroenterology Research and Practice

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Background and Aims. Linked color imaging (LCI) helps screen and diagnose for early gastric cancer by color contrast in different mucosa. RGB (red, green, and blue) pixel brightness quantifies colors, which is relatively objective. Limited studies have combined LCI images with RGB to help screen for early gastric cancer (EGC). We aimed to evaluate the RGB pixel brightness characteristics of EGC and noncancer areas in LCI images. Methods. We retrospectively reviewed early gastric cancer (EGC) patients and LCI images. All pictures were evaluated by at least two endoscopic physicians. RGB pixel brightness analysis of LCI images was performed in MATLAB software to compare the cancer with noncancer areas. Receiver operating characteristic (ROC) curve was analyzed for sensitivity, specificity, cut-off, and area under the curve (AUC). Results. Overall, 38 early gastric cancer patients were enrolled with 38 LCI images. Pixel brightness of red, green, and blue in cancer was remarkably higher than those in noncancer areas (190.24±37.10 vs. 160.00±40.35, p<0.001; 117.96±33.91 vs. 105.33±30.01, p=0.039; 114.36±34.88 vs. 90.93±30.14, p<0.001, respectively). Helicobacter plyori (Hp) infection was not relevant to RGB distribution of EGC. Whether the score of Kyoto Classification of Gastritis (KCG) is ≥4 or <4, the pixel brightness of red, green, and blue was not disturbed in both cancer and noncancer (p>0.05). Receiver operating characteristic (ROC) curve for differentiating cancer from noncancer was calculated. The maximum area under the curve (AUC) was 0.767 in B/G, with a sensitivity of 0.605, a specificity of 0.921, and a cut-off of 0.97. Conclusions. RGB pixel brightness was useful and more objective in distinguishing early gastric cancer for LCI images.

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“…31 However, this modality is less than ideal because it is too dark when used in the stomach. 20 It may therefore fail to identify subtle changes in EGC after eradication. Because LCI provides a brighter image, it is expected be more useful for detecting slight irregularities of the gastric surface in patients who have had successful eradication.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17][18][19] LCI improve the visibility of EGC when evaluated using subjective or objective criteria. [20][21][22][23][24] However, limited information is available concerning the efficacy of LCI for detecting EGC after eradication. Design of previous studies was unsatisfactory because only still images of EGC were evaluated.…”

Section: Introductionmentioning

confidence: 99%

Comparison of endoscopic visibility and miss rate for early gastric cancers after Helicobacter pylori eradication with white‐light imaging versus linked color imaging

Kitagawa

Suzuki

Nankinzan

et al. 2019

Digestive Endoscopy

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Background and Aim We aimed to investigate whether linked color imaging (LCI) improves endoscopic visibility of early gastric cancers (EGC) after Helicobacter pylori eradication, which are often difficult to detect, and reduces the miss rate when compared with white‐light imaging (WLI). Methods The visibility study used two images, one each with WLI and LCI, from 84 consecutive EGC after H. pylori eradication. Endoscopic visibility was evaluated using a visibility score and color difference (CD) value. To analyze miss rates, we studied a library of recorded videos using both WLI and LCI for 70 other consecutive patients after H. pylori eradication, among whom 19 had EGC. Endoscopic screening was done using the same protocol to map the entire stomach. Six endoscopists reviewed the videos in a randomized order. Miss rates of EGC were compared among the modalities. Results Mean [(±standard deviation) visibility scores with LCI were significantly higher than those with WLI (3.19 ± 0.84 vs 2.52 ± 0.98, P < 0.001), as were mean CD values (26.3 ± 9.1 vs 13.6 ± 6.3, P < 0.001). Miss rates of the six endoscopists were significantly lower with LCI than with WLI (30.7% vs 64.9%, P < 0.001). Both expert and trainee endoscopists had significantly better results with LCI than with WLI. Conclusions Linked color imaging significantly improved the visibility of EGC after H. pylori eradication compared with WLI using both subjective and objective criteria. Furthermore, LCI significantly reduced miss rates of these lesions compared with WLI.

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Linked colour imaging benefits the endoscopic diagnosis of distal gastric diseases

Cited by 20 publications

References 23 publications

Linked color imaging confers benefits in profiling H. pylori infection in the stomach

Linked color imaging confers benefits in profiling H. pylori infection in the stomach

RGB Pixel Brightness Characteristics of Linked Color Imaging in Early Gastric Cancer: A Pilot Study

Comparison of endoscopic visibility and miss rate for early gastric cancers after Helicobacter pylori eradication with white‐light imaging versus linked color imaging

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