scholarly journals Linked color imaging can improve the visibility of superficial non-ampullary duodenal epithelial tumors

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kenichiro Okimoto ◽  
Daisuke Maruoka ◽  
Tomoaki Matsumura ◽  
Mamoru Tokunaga ◽  
Tatsuya Kaneko ◽  
...  
Keyword(s):  
Medical Information ◽  
Color Space ◽  
Duodenal Mucosa ◽  
Blue Laser ◽  
University Hospital ◽  
Color Imaging ◽  
Epithelial Tumors ◽  
Color Differences ◽  
Linked Color Imaging ◽  
The University

AbstractThe current study aimed to evaluate the efficacy of linked color imaging (LCI) in improving the visibility of superficial non-ampullary duodenal epithelial tumors (SNADETs). We prospectively evaluated 44 consecutive patients diagnosed with SNADETs. Three trainees and three experts assessed the visibility scores of white light imaging (WLI), LCI, and blue laser imaging-bright (BLI-b) for SNADETs, which ranged from 1 (not detectable without repeated cautious examination) to 4 (excellent visibility). In addition, the L* a* b* color values and color differences (ΔE*) were evaluated using the CIELAB color space system. For SNADETs, the visibility scores of LCI (3.53 ± 0.59) were significantly higher than those of WLI and BLI-b (2.66 ± 0.79 and 3.41 ± 0.64, respectively). The color differences (ΔE*) between SNADETs and the adjacent normal duodenal mucosa in LCI mode (19.09 ± 8.33) were significantly higher than those in WLI and BLI-b modes (8.67 ± 4.81 and 12.92 ± 7.95, respectively). In addition, the visibility score of SNADETs and the color differences in LCI mode were significantly higher than those in WLI and BLI-b modes regardless of the presence of milk white mucosa (MWM). LCI has potential benefits, and it is considered a promising clinical modality that can increase the visibility of SNADETs regardless of the presence of MWM.This study was registered at the University Hospital Medical Information Network (UMIN000028840).

scholarly journals The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mamoru Tokunaga ◽  
Tomoaki Matsumura ◽  
Kentaro Ishikawa ◽  
Tatsuya Kaneko ◽  
Hirotaka Oura ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Color Space ◽  
Color Difference ◽  
Blue Laser ◽  
Color Imaging ◽  
Color Differences ◽  
Blue Laser Imaging ◽  
Linked Color Imaging

Background. The present study aimed to evaluate the efficacy of linked color imaging (LCI) in diagnosing Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Methods. A total of 112 and 12 consecutive patients with BE and EAC were analyzed. The visibility scores of BE and EAC ranging from 4 (excellent visibility) to 0 (not detectable) were evaluated by three trainees and three experts using white light imaging (WLI), LCI mode, and blue laser imaging bright (BLI-b) mode. In addition, L ∗ a ∗ b ∗ color values and color differences ( Δ E ∗ ) were evaluated using the CIELAB color space system. Results. The visibility score of the BE in LCI mode ( 2.94 ± 1.32 ) was significantly higher than those in WLI ( 2.46 ± 1.48 ) and BLI-b mode ( 2.35 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent gastric mucosa in LCI mode ( 17.11 ± 8.53 ) was significantly higher than those in other modes ( 12.52 ± 9.37 in WLI and 11.96 ± 6.59 in BLI-b mode, p < 0.01 ). The visibility scores of EAC in LCI mode ( 2.56 ± 1.47 ) and BLI-b mode ( 2.51 ± 1.28 ) were significantly higher than that in WLI ( 1.64 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent normal Barrett’s mucosa in LCI mode ( 19.96 ± 7.97 ) was significantly higher than that in WLI ( 12.95 ± 11.86 ) ( p = 0.03 ). Conclusion. The present findings suggest that LCI increases the visibility of BE and EAC and contributes to the improvement of the detection of these lesions.

scholarly journals Linked color imaging improves visibility of reflux esophagitis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tsutomu Takeda ◽  
Daisuke Asaoka ◽  
Daiki Abe ◽  
Maiko Suzuki ◽  
Yuta Nakagawa ◽  
...  
Keyword(s):  
Los Angeles ◽  
Reflux Esophagitis ◽  
White Light ◽  
Color Space ◽  
Blue Laser ◽  
Esophageal Mucosa ◽  
Color Imaging ◽  
Rater Reliability ◽  
Color Differences ◽  
Linked Color Imaging

Abstract Background With more prevalent gastroesophageal reflux disease comes increased cases of Barrett's esophagus and esophageal adenocarcinoma. Image-enhanced endoscopy using linked-color imaging (LCI) differentiates between mucosal colors. We compared LCI, white light imaging (WLI), and blue LASER imaging (BLI) in diagnosing reflux esophagitis (RE). Methods Consecutive RE patients (modified Los Angeles [LA] classification system) who underwent esophagogastroduodenoscopy using WLI, LCI, and BLI between April 2017 and March 2019 were selected retrospectively. Ten endoscopists compared WLI with LCI or BLI using 142 images from 142 patients. Visibility changes were scored by endoscopists as follows: 5, improved; 4, somewhat improved; 3, equivalent; 2, somewhat decreased; and 1, decreased. For total scores, 40 points was considered improved visibility, 21–39 points was comparable to white light, and < 20 points equaled decreased visibility. Inter- and intra-rater reliabilities (Intra-class Correlation Coefficient [ICC]) were also evaluated. Images showing color differences (ΔE*) and L* a* b* color values in RE and adjacent esophageal mucosae were assessed using CIELAB, a color space system. Results The mean age of patients was 67.1 years (range: 27–89; 63 males, 79 females). RE LA grades observed included 52 M, 52 A, 24 B, 11 C, and 3 D. Compared with WLI, all RE cases showed improved visibility: 28.2% (40/142), LA grade M: 19.2% (10/52), LA grade A: 34.6% (18/52), LA grade B: 37.5% (9/24), LA grade C: 27.3% (3/11), and LA grade D: 0% (0/3) in LCI, and for all RE cases: 0% in BLI. LCI was not associated with decreased visibility. The LCI inter-rater reliability was “moderate” for LA grade M and “substantial” for erosive RE. The LCI intra-rater reliability was “moderate–substantial” for trainees and experts. Color differences were WLI: 12.3, LCI: 22.7 in LA grade M; and WLI: 18.2, LCI: 31.9 in erosive RE (P < 0.001 for WLI vs. LCI). Conclusion LCI versus WLI and BLI led to improved visibility for RE after subjective and objective evaluations. Visibility and the ICC for minimal change esophagitis were lower than for erosive RE for LCI. With LCI, RE images contrasting better with the surrounding esophageal mucosa were more clearly viewed.

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

2018 ◽  
Vol 06 (03) ◽  
pp. E322-E334 ◽  
Author(s):  
Daisaku Fujimoto ◽  
Naoki Muguruma ◽  
Koichi Okamoto ◽  
Yasuteru Fujino ◽  
Kaizo Kagemoto ◽  
...  
Keyword(s):  
Detection Rate ◽  
Controlled Trial ◽  
Color Space ◽  
Blue Laser ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Color Imaging ◽  
Detection Rates ◽  
Still Image ◽  
Linked Color Imaging

Abstract 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.

scholarly journals Usefulness of cold polypectomy under linked color imaging

2020 ◽  
Vol 08 (01) ◽  
pp. E87-E91
Author(s):  
Takuto Suzuki ◽  
Yoshiyasu Kitagawa ◽  
Rino Nankinzan ◽  
Taketo Yamaguchi
Keyword(s):  
Medical Information ◽  
Treatment Method ◽  
University Hospital ◽  
Colon Polyps ◽  
Color Imaging ◽  
En Bloc ◽  
Cold Snare Polypectomy ◽  
Linked Color Imaging ◽  
Tumor Remnant ◽  
Snare Polypectomy

Abstract Background and study aims Cold polypectomy is becoming popular for treatment of colon polyps due to its safety and convenience, but there is still the problem of tumor remnants. Because linked color imaging (LCI) improves polyp visibility, cold polypectomy under LCI is anticipated to reduce the tumor remnant rate. Therefore, we investigated the usefulness of this procedure. Patients and methods Fifty patients scheduled to undergo cold polypectomy for treatment of colon polyps < 10 mm and assumed to be adenomas were registered prospectively. After performing cold snare polypectomy (CSP) under LCI, biopsy was performed at two resection margin sites for each polyp to determine the tumor remnant rate. Results A total of 145 lesions were treated by CSP. Of the 139 lesions in which polyps were retrievable and diagnosed as adenomas pathologically, one lesion was recognized as a remnant adenoma on biopsy (remnant rate: 0.7 % [95 % CI: 0.0–4.4]). This remnant rate was extremely low. Treatment results were extremely promising given that en bloc resection, post-procedure bleeding, and perforation rates were 100 %, 0 %, and 0 %, respectively. Conclusion Cold snare polypectomy under LCI may be an effective treatment method capable of reducing the tumor remnant rate. This trial was approved by our Institutional Ethics Committee and registered at the University Hospital Medical Information Network (UMIN 000033690).

scholarly journals Linked color imaging (LCI), a novel image-enhanced endoscopy technology, emphasizes the color of early gastric cancer

2017 ◽  
Vol 05 (10) ◽  
pp. E1005-E1013 ◽  
Author(s):  
Hiromitsu Kanzaki ◽  
Ryuta Takenaka ◽  
Yoshiro Kawahara ◽  
Daisuke Kawai ◽  
Yuka Obayashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Color Space ◽  
Region Of Interest ◽  
Color Difference ◽  
Blue Laser ◽  
Color Imaging ◽  
Blue Laser Imaging ◽  
Color Value ◽  
Linked Color Imaging

Abstract Background and study aims Linked color imaging (LCI) and blue laser imaging (BLI) are novel image-enhanced endoscopy technologies with strong, unique color enhancement. We investigated the efficacy of LCI and BLI-bright compared to conventional white light imaging (WLI) by measuring the color difference between early gastric cancer lesions and the surrounding mucosa. Patients and methods Images of early gastric cancer scheduled for endoscopic submucosal dissection were captured by LCI, BLI-bright, and WLI under the same conditions. Color values of the lesion and surrounding mucosa were defined as the average of the color value in each region of interest. Color differences between the lesion and surrounding mucosa (ΔE) were examined in each mode. The color value was assessed using the CIE L*a*b* color space (CIE: Commission Internationale d’Eclairage). Results We collected images of 43 lesions from 42 patients. Average ΔE values with LCI, BLI-bright, and WLI were 11.02, 5.04, and 5.99, respectively. The ΔE was significantly higher with LCI than with WLI (P < 0.001). Limited to cases of small ΔE with WLI, the ΔE was approximately 3 times higher with LCI than with WLI (7.18 vs. 2.25). The ΔE with LCI was larger when the surrounding mucosa had severe intestinal metaplasia (P = 0.04). The average color value of a lesion and the surrounding mucosa differed. This value did not have a sufficient cut-off point between the lesion and surrounding mucosa to distinguish them, even with LCI. Conclusion LCI had a larger ΔE than WLI. It may allow easy recognition and early detection of gastric cancer, even for inexperienced endoscopists.

scholarly journals Objective Endoscopic Analysis with Linked Color Imaging regarding Gastric Mucosal Atrophy: A Pilot Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Kazuhiro Mizukami ◽  
Ryo Ogawa ◽  
Kazuhisa Okamoto ◽  
Mitsutaka Shuto ◽  
Kensuke Fukuda ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Color Space ◽  
Color Difference ◽  
Infection Status ◽  
Color Imaging ◽  
Mucosal Atrophy ◽  
Color Differences ◽  
Euclidean Distances ◽  
Linked Color Imaging ◽  
White Light Imaging

Objectives. We aimed to determine whether linked color imaging (LCI), a new image-enhanced endoscopy that enhances subtle differences in mucosal colors, can distinguish the border of endoscopic mucosal atrophy. Methods. This study included 30 patients with atrophic gastritis. In endoscopy, we continuously took images in the same composition with both LCI and white light imaging (WLI). In each image, the color values of atrophic and nonatrophic mucosae were quantified using the International Commission on Illumination 1976 (L∗, a∗, b∗) color space. Color differences at the atrophic border, defined as Euclidean distances of color values between the atrophic and nonatrophic mucosae, were compared between WLI and LCI for the overall cohort and separately for patients with Helicobacter pylori infection status. Results. We found that the color difference became significantly higher with LCI than with WLI in the overall samples of 90 points in 30 patients. LCI was 14.79 ± 6.68, and WLI was 11.06 ± 5.44 (P<0.00001). LCI was also more effective in both of the Helicobacter pylori-infected group (P=0.00003) and the Helicobacter pylori-eradicated group (P=0.00002). Conclusions. LCI allows clear endoscopic visualization of the atrophic border under various conditions of gastritis, regardless of Helicobacter pylori infection status.

scholarly journals A CNN CADx System for Multimodal Classification of Colorectal Polyps Combining WL, BLI, and LCI Modalities

2020 ◽  
Vol 10 (15) ◽  
pp. 5040 ◽  
Author(s):  
Roger Fonollà ◽  
Quirine E. W. van der Zander ◽  
Ramon M. Schreuder ◽  
Ad A. M. Masclee ◽  
Erik J. Schoon ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Colorectal Polyps ◽  
Blue Laser ◽  
Classification Model ◽  
Misclassification Rate ◽  
Laser Imaging ◽  
Color Imaging ◽  
Additional Information ◽  
Blue Laser Imaging ◽  
Linked Color Imaging

Colorectal polyps are critical indicators of colorectal cancer (CRC). Blue Laser Imaging and Linked Color Imaging are two modalities that allow improved visualization of the colon. In conjunction with the Blue Laser Imaging (BLI) Adenoma Serrated International Classification (BASIC) classification, endoscopists are capable of distinguishing benign and pre-malignant polyps. Despite these advancements, this classification still prevails a high misclassification rate for pre-malignant colorectal polyps. This work proposes a computer aided diagnosis (CADx) system that exploits the additional information contained in two novel imaging modalities, enabling more informative decision-making during colonoscopy. We train and benchmark six commonly used CNN architectures and compare the results with 19 endoscopists that employed the standard clinical classification model (BASIC). The proposed CADx system for classifying colorectal polyps achieves an area under the curve (AUC) of 0.97. Furthermore, we incorporate visual explanatory information together with a probability score, jointly computed from White Light, Blue Laser Imaging, and Linked Color Imaging. Our CADx system for automatic polyp malignancy classification facilitates future advances towards patient safety and may reduce time-consuming and costly histology assessment.

scholarly journals Linked color imaging for the detection of early gastrointestinal neoplasms

2019 ◽  
Vol 12 ◽  
pp. 175628481988524 ◽  
Author(s):  
Satoshi Shinozaki ◽  
Hiroyuki Osawa ◽  
Yoshikazu Hayashi ◽  
Alan Kawarai Lefor ◽  
Hironori Yamamoto
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Blue Laser ◽  
Gastrointestinal Neoplasms ◽  
Color Contrast ◽  
Color Imaging ◽  
Adenoma Detection ◽  
Blue Laser Imaging ◽  
Linked Color Imaging

In routine upper and lower gastrointestinal endoscopy, overlooking neoplastic lesions is inevitable even for well-trained endoscopists. Various methods have been reported to improve the detection of gastrointestinal neoplasms including chromoendoscopy, special endoscopes, and processor and image enhanced technologies. Equipment-based image enhanced endoscopy (e-IEE) using narrow band imaging (NBI) and blue laser imaging (BLI) is useful to characterize known lesions with magnification at a close-up view. However, they are not useful for the early detection of superficial, pale neoplasms, or both because of the weak image at a distant view in a wide lumen such as the stomach or colon. Linked color imaging (LCI) is a novel pre- and post-processing technology developed by Fujifilm Corporation that has sufficient brightness to illuminate a wide lumen. LCI delineates early gastric cancers as orange–red and intestinal metaplasia as purple. LCI improves the adenoma detection rate in the colon and decreases the polyp miss rate. LCI contributes to the detection of superficial lesions throughout the gastrointestinal tract by enhancing the color contrast between the neoplasm and the surrounding mucosa. LCI can distinguish them by their specific color allocation based mainly on the distribution of capillaries. The authors believe that moving forward, LCI should be used in routine upper and lower gastrointestinal endoscopy.

Blue laser imaging and linked color imaging improve the color difference value and visibility of colorectal polyps in underwater conditions

2020 ◽  
Vol 32 (5) ◽  
pp. 791-800 ◽  
Author(s):  
Yasushi Yamasaki ◽  
Keita Harada ◽  
Shumpei Yamamoto ◽  
Eriko Yasutomi ◽  
Shotaro Okanoue ◽  
...  
Keyword(s):  
Color Difference ◽  
Colorectal Polyps ◽  
Blue Laser ◽  
Laser Imaging ◽  
Color Imaging ◽  
Blue Laser Imaging ◽  
Linked Color Imaging
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