TY - JOUR
T1 - Detection of Colorectal Neoplasms Using Linked Color Imaging
T2 - A Prospective, Randomized, Tandem Colonoscopy Trial
AU - Hasegawa, Issei
AU - Yamamura, Takeshi
AU - Suzuki, Hiroto
AU - Maeda, Keiko
AU - Sawada, Tsunaki
AU - Mizutani, Yasuyuki
AU - Ishikawa, Eri
AU - Ishikawa, Takuya
AU - Kakushima, Naomi
AU - Furukawa, Kazuhiro
AU - Ohno, Eizaburo
AU - Kawashima, Hiroki
AU - Nakamura, Masanao
AU - Fujishiro, Mitsuhiro
N1 - Publisher Copyright:
© 2021 AGA Institute
PY - 2021/8
Y1 - 2021/8
N2 - Background and aims: A higher adenoma detection rate (ADR) has been shown to be related to a lower incidence and mortality of colorectal cancer. We analyzed the efficacy of linked color imaging (LCI) by assessing the detection, miss, and visibility of various featured adenomas as compared with white light imaging (WLI). Methods: This was a prospective, randomized, tandem trial. The participants were randomly assigned to 2 groups: first observation by LCI, then second observation by WLI (LCI group); or both observations by WLI (WLI group). Suspected neoplastic lesions were resected after magnifying image-enhanced endoscopy. The primary outcome was to compare the ADR during the first observation. Secondary outcomes included evaluation of adenoma miss rate (AMR) and visibility score. Results: A total of 780 patients were randomized, 700 of whom were included in the final analysis. The ADR was 69.6% and 63.2% in the LCI and WLI groups, respectively, with no significant difference. However, LCI improved the average ADR in low-detectors compared with high-detectors (76.0% vs 55.1%; P < .001). Total AMR was 20.6% in the LCI group, which was significantly lower than that in the WLI group (31.1%) (P < .001). AMR in the LCI group was significantly lower, especially for diminutive adenomas (23.4% vs 35.1%; P < .001) and nonpolypoid lesions (25.6% vs 37.9%; P < .001) compared with the WLI group. Conclusion: Although both methods provided a similar ADR, LCI had a lower AMR than WLI. LCI could benefit endoscopists with lower ADR, an observation that warrants additional study. (UMIN Clinical Trials Registry, Number: UMIN000026359).
AB - Background and aims: A higher adenoma detection rate (ADR) has been shown to be related to a lower incidence and mortality of colorectal cancer. We analyzed the efficacy of linked color imaging (LCI) by assessing the detection, miss, and visibility of various featured adenomas as compared with white light imaging (WLI). Methods: This was a prospective, randomized, tandem trial. The participants were randomly assigned to 2 groups: first observation by LCI, then second observation by WLI (LCI group); or both observations by WLI (WLI group). Suspected neoplastic lesions were resected after magnifying image-enhanced endoscopy. The primary outcome was to compare the ADR during the first observation. Secondary outcomes included evaluation of adenoma miss rate (AMR) and visibility score. Results: A total of 780 patients were randomized, 700 of whom were included in the final analysis. The ADR was 69.6% and 63.2% in the LCI and WLI groups, respectively, with no significant difference. However, LCI improved the average ADR in low-detectors compared with high-detectors (76.0% vs 55.1%; P < .001). Total AMR was 20.6% in the LCI group, which was significantly lower than that in the WLI group (31.1%) (P < .001). AMR in the LCI group was significantly lower, especially for diminutive adenomas (23.4% vs 35.1%; P < .001) and nonpolypoid lesions (25.6% vs 37.9%; P < .001) compared with the WLI group. Conclusion: Although both methods provided a similar ADR, LCI had a lower AMR than WLI. LCI could benefit endoscopists with lower ADR, an observation that warrants additional study. (UMIN Clinical Trials Registry, Number: UMIN000026359).
UR - http://www.scopus.com/inward/record.url?scp=85107945522&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107945522&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2021.04.004
DO - 10.1016/j.cgh.2021.04.004
M3 - Article
C2 - 33839277
AN - SCOPUS:85107945522
SN - 1542-3565
VL - 19
SP - 1708-1716.e4
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 8
ER -
