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

Abstract

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, $\text{L}\ast \text{a}\ast \text{b}\ast$ color values and color differences ( $\Delta \text{E}\ast$ ) were evaluated using the CIELAB color space system. Results. The visibility score of the BE in LCI mode ( $2.94\pm 1.32$ ) was significantly higher than those in WLI ( $2.46\pm 1.48$ ) and BLI-b mode ( $2.35\pm 1.46$ ) ( $p<0.01$ ). The color difference ( $\Delta \text{E}\ast$ ) from the adjacent gastric mucosa in LCI mode ( $17.11\pm 8.53$ ) was significantly higher than those in other modes ( $12.52\pm 9.37$ in WLI and $11.96\pm 6.59$ in BLI-b mode, $p<0.01$ ). The visibility scores of EAC in LCI mode ( $2.56\pm 1.47$ ) and BLI-b mode ( $2.51\pm 1.28$ ) were significantly higher than that in WLI ( $1.64\pm 1.46$ ) ( $p<0.01$ ). The color difference ( $\Delta \text{E}\ast$ ) from the adjacent normal Barrett’s mucosa in LCI mode ( $19.96\pm 7.97$ ) was significantly higher than that in WLI ( $12.95\pm 11.86$ ) ( $p=0.03$ ). 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.