Magnified endoscopic observation of small depressed gastric lesions using linked color imaging with indigo carmine dye

Kitagawa, Yoshiyasu; Hara, Taro; Ikebe, Dai; Nankinzan, Rino; Takashiro, Hideyuki; Kobayashi, Ryosuke; Nakamura, Kazuyoshi; Yamaguchi, Taketo; Suzuki, Takuto

doi:10.1055/s-0043-119212

Cited by 22 publications

(19 citation statements)

References 10 publications

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“…LCI is a novel image-enhancement technology based on images captured under conditions similar to those of BLI-bright 14 15 . It utilizes digital processing to enhance slight color differences in hue in the red region of the spectrum 22 ( Supplementary Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps

et al. 2018

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Background and study aims Although new image-enhanced endoscopy (IEE) technologies such as blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI) have been developed, their utility for the detection of sessile serrated adenoma/polyps (SSA/Ps) is still unclear. This study aimed to evaluate the utility of BLI, BLI-bright, and LCI for SSA/P detection in still image examinations and in a prospective randomized controlled trial (RCT). Patients and methods A group of 6 expert and non-expert endoscopists read 200 endoscopic still images containing SSA/P lesions using white light image (WLI), BLI, BLI-bright, and LCI. Color differences were calculated using the color space method. A prospective RCT of tandem colonoscopy with WLI and LCI was performed. Patients with SSA/P and those with a history of SSA/P that had been endoscopically removed were enrolled and randomly allocated to WLI-LCI or LCI-WLI groups. Additional endoscopic detection rates for SSA/P were compared between the 2 groups. Results LCI showed the highest SSA/P detection rate among the 4 modes for both expert and non-expert endoscopists. The detection rate with LCI for the 6 expert endoscopists (mean 98.3 ± standard deviation 2.0 %) was significantly higher than that with WLI (86.7 ± 6.0 %, P < 0.01). Likewise, the detection rate with LCI for the 6 non-expert endoscopists (92.3 ± 2.9 %) was significantly higher than that with WLI (72.7 ± 11.5 %, P < 0.01). The color difference of SSA/P with LCI was the highest among the 4 modes, and was significantly higher than with WLI (median 15.9, (interquartile range 13.7 – 20.6) vs. 10.2, (7.6 – 14.2); P < 0.0001). In the RCT, a total of 44 patients (WLI-LCI 22 vs. LCI-WLI 22) underwent colonoscopy. The additional detection rate for SSA/P in the second inspection in the WLI-LCI group (21.6 %, 8/37) was significantly higher than in the LCI-WLI group (3.2 %, 1/31; P = 0.02). The small, flat, non-mucus and isochromatic SSA/Ps in the transverse colon were detected more frequently in the second inspection with LCI. Conclusions LCI was the most sensitive mode for SSA/P detection among WLI, BLI, BLI-bright, and LCI in the still image examinations. Our RCT strongly suggests that LCI is superior to conventional WLI for SSA/P detection during colonoscopy. UMIN000017599.

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Section: Methodsmentioning

confidence: 99%

Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps

et al. 2018

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“…Furthermore, drug administration is not required for OS imaging, which is a major strength of this method compared to other modalities. Secondly, assessment with other image-enhanced endoscopic modalities such as Blue Laser Imaging (BLI) [22,23] and Linked Color Imaging (LCI) [24,25] can be easily performed concomitantly Examining accuracy rates of discriminating algorithms for the tumor vs. its adherent substances. The scatter plots in the validation set were then used to verify the diagnostic reliability of the discrimination between the tumor and its adherent substances: 95.9% (discriminating algorithms for blood vs. reddish tumor) and 96.0% (discriminating algorithms for white coating vs. whitish tumor).…”

Section: Plos Onementioning

confidence: 99%

A study of evaluating specific tissue oxygen saturation values of gastrointestinal tumors by removing adherent substances in oxygen saturation imaging

et al. 2021

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Objectives Oxygen saturation (OS) imaging is a new method of endoscopic imaging that has clinical applications in oncology which can directly measure tissue oxygen saturation (Sto2) of the surface of gastrointestinal tract without any additional drugs or devices. This imaging technology is expected to contribute to research into cancer biology which leads to clinical benefit such as prediction to efficacy of chemotherapy or radiotherapy. However, adherent substances on tumors such as blood and white coating, pose a challenge for accurate measurements of the StO2 values in tumors. The aim of this study was to develop algorithms for discriminating between the tumors and their adherent substances, and to investigate whether it is possible to evaluate the tumor specific StO2 values excluding adherent substances during OS imaging. Methods We plotted areas of tumors and their adherent substances using white-light images of 50 upper digestive tumors: blood (68 plots); reddish tumor (83 plots); white coating (89 plots); and whitish tumor (79 plots). Scatter diagrams and discriminating algorithms using spectrum signal intensity values were constructed and verified using validation datasets. StO2 values were compared between the tumors and tumor adherent substances using OS images of gastrointestinal tumors. Results The discriminating algorithms and their accuracy rates (AR) were as follows: blood vs. reddish tumor: Y> - 4.90X+7.13 (AR: 95.9%) and white coating vs. whitish tumor: Y< -0.52X+0.17 (AR: 96.0%). The StO2 values (median, [range]) were as follows: blood, 79.3% [37.8%–100.0%]; reddish tumor, 74.5% [62.0%–86.9%]; white coating, 73.8% [42.1%–100.0%]; and whitish tumor, 65.7% [53.0%–76.3%]. Conclusions OS imaging is strongly influenced by adherent substances for evaluating the specific StO2 value of tumors; therefore, it is important to eliminate the information of adherent substances for clinical application of OS imaging.

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“…Recently, new methods for the endoscopic diagnosis of gastric cancer and gastric intestinal metaplasia using linked color imaging (LCI) have been reported [6,7]. LCI is a unique image-enhanced endoscopy method that enables the visualization of red lesions that appear as redder and whitish red lesions that are whiter than the mucosal color [7].…”

Section: Introductionmentioning

confidence: 99%

Accuracies of Endoscopic Diagnosis of Helicobacter pylori-Gastritis: Multicenter Prospective Study Using White Light Imaging and Linked Color Imaging

et al. 2019

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Introduction: The diagnosis of Helicobacter pylori infection status with white light imaging (WLI) is difficult. We evaluated the accuracies of using WLI and linked color imaging (LCI) for diagnosing H. pylori-active gastritis in a multicenter prospective study setting. Methods: Patients who underwent esophagogastroduodenoscopy were prospectively included. The image collection process was randomized and anonymous, and the image set included 4 images with WLI or 4 images with LCI in the corpus that 5 reviewers separately evaluated. Active gastritis was defined as positive when there was diffuse redness in WLI and crimson coloring in LCI. The H. pylori infection status was determined by the urea breath test and the serum antibody test. Cases in which both test results were negative but atrophy or intestinal metaplasia was histologically confirmed were defined as past infections. The primary endpoint was the diagnostic accuracies of WLI and LCI, and the secondary endpoint was inter-observer agreement. Results: Data for 127 patients were analyzed. The endoscopic diagnostic accuracy for active gastritis was 79.5 (sensitivity of 84.4 and specificity of 74.6) with WLI and 86.6 (sensitivity of 84.4 and specificity of 88.9) with LCI (p = 0.029). LCI significantly improved the accuracy in patients with past infections over WLI (36.8 in WLI and 78.9 in LCI, p < 0.01). The κ values were 0.59 in WLI and 0.70 in LCI. Conclusions: LCI is useful for endoscopic diagnosis of H. pylori-active or inactive gastritis, and it is advantageous for patients with past infections of inactive gastritis.

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Magnified endoscopic observation of small depressed gastric lesions using linked color imaging with indigo carmine dye

Abstract: M-Chromo-LCI is expected to become a useful modality for the accurate diagnosis of gastric lesions.

Cited by 22 publications

References 10 publications

Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps

Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps

A study of evaluating specific tissue oxygen saturation values of gastrointestinal tumors by removing adherent substances in oxygen saturation imaging

Accuracies of Endoscopic Diagnosis of Helicobacter pylori-Gastritis: Multicenter Prospective Study Using White Light Imaging and Linked Color Imaging

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