Linked-color Imaging May Help Improve the Visibility of Superficial Barrett's Esophageal Adenocarcinoma by Increasing the Color Difference

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.

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Sa1158 – Linked Color Imaging (LCI), a Novel Image-Enhanced Endoscopy, is Useful for Improving Visibility of Superficial Barrett's Esophageal Adenocarcinoma

Gastroenterology ◽

10.1016/s0016-5085(19)37540-7 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-289

Author(s):

Masahiro Saito ◽

Tomoyuki Koike ◽

Yasuaki Abe ◽

Xiaoyi Jin ◽

Waku Hatta ◽

...

Keyword(s):

Esophageal Adenocarcinoma ◽

Color Imaging ◽

Linked Color Imaging ◽

Barrett’S Esophageal Adenocarcinoma

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The Color Difference between Differentiated Early Gastric Cancer and Suspicious Mucosal Areas on Linked Color Imaging

Digestion ◽

10.1159/000503958 ◽

2019 ◽

Vol 101 (Suppl. 1) ◽

pp. 25-30

Author(s):

Hiromitsu Kanzaki ◽

Yoshiro Kawahara ◽

Hiroyuki Okada

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Color Difference ◽

Color Imaging ◽

Linked Color Imaging

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Mo1179 LINKED COLOR IMAGING IMPROVES THE VISIBILITY OF BARRETT’S ESOPHAGUS AND ESOPHAGEAL ADENOCARCINOMA

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.1266 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB451

Author(s):

Mamoru Tokunaga ◽

Tomoaki Matsumura ◽

Kentaro Ishikawa ◽

Naoki Akizue ◽

Yuki Ohta ◽

...

Keyword(s):

Barrett’S Esophagus ◽

Esophageal Adenocarcinoma ◽

Barrett's Esophagus ◽

Color Imaging ◽

Linked Color Imaging

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

Digestive Endoscopy ◽

10.1111/den.13581 ◽

2020 ◽

Vol 32 (5) ◽

pp. 791-800 ◽

Cited By ~ 1

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

Endoscopy International Open ◽

10.1055/s-0043-117881 ◽

2017 ◽

Vol 05 (10) ◽

pp. E1005-E1013 ◽

Cited By ~ 25

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.

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

Gastroenterology Research and Practice ◽

10.1155/2017/5054237 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

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.

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