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

• Material Type: 博士論文
• Title: Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps
• Author/Editor: 藤本, 大策; 六車, 直樹; 岡本, 耕一; 藤野, 泰輝; ,; 岡田, 泰行; 三井, 康裕; 北村, 晋志; 木村, 哲夫; 宮本, 弘志; 坂東, 良美; 高山, 哲治
• Author Heading: 藤本, 大策; 六車, 直樹; 岡本, 耕一; 藤野, 泰輝; ,; 岡田, 泰行; 三井, 康裕; 北村, 晋志; 木村, 哲夫; 宮本, 弘志; 坂東, 良美; 高山, 哲治
• Publication, Distribution, etc.: Thieme
• Publication Date: 2018-03-07
• Publication Date (W3CDTF): 2018-03-07
• Alternative Title: Linked color imagingはsessile serrated adenoma/polypsの検出率を向上させる
• Periodical title: Endoscopy International Open
• No. or year of volume/issue: 6 3
• Volume: 6
• Issue: 3
• Pages: E322-E334
• ISSN (Periodical Title): ISSN : 2364-3722; ISSN : 2196-9736
• Degree grantor/type: 徳島大学
• Date Granted: 2018-03-23
• Dissertation Number: 甲第3133号
• Degree Type: 博士（医学）
• Text Language Code: jpn
• Subject Heading: SSA/P; LCI; Colorectal cancer; IEE
• Target Audience: 一般
• Note (General): 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.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Rights (production): © Georg Thieme Verlag KG 2018 This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
• Related Material (DOI): 10.1055/s-0043-124469
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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