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Home  > Press Release  > Linked Color Imaging Focused on Imaging for Neoplasm Detection in Upper Gastrointestinal Tract. A Randomized Trial

Linked Color Imaging Focused on Imaging for Neoplasm Detection in Upper Gastrointestinal Tract. A Randomized Trial

Abstract

Background:
Linked color imaging (LCI) is a new image-enhanced endoscopy technique that allows users to recognize slight differences in mucosal color.

Objective:
To compare the performance of LCI with white light imaging (WLI) in detecting neoplastic lesions in the upper gastrointestinal tract.

Design:
A controlled, multicenter trial with randomization using minimization. (University Hospital Medical Information Network Clinical Trials Registry: UMIN000023863)

Setting:
16 university hospitals and 3 tertiary care hospitals in Japan.

Patients:
1502 patients with known previous or current cancer of the gastrointestinal tract and undergoing surveillance for gastrointestinal cancer.

Intervention:
WLI followed by LCI examination (WLI group) or LCI followed by WLI examination (LCI group).

Measurements:
Diagnosis of 1 or more neoplastic lesions in the pharynx, esophagus, or stomach in the first examination (primary outcome) and 1 or more neoplastic lesions overlooked in the first examination (secondary outcome).

Results:
752 patients were assigned to the WLI group and 750 to the LCI group. The percentage of patients with 1 or more neoplastic lesions diagnosed in the first examination was higher with LCI than with WLI (60 of 750 patients or 8.0% [95% CI, 6.2% to 10.2%] vs. 36 of 752 patients or 4.8% [CI, 3.4% to 6.6%]; risk ratio, 1.67 [CI, 1.12 to 2.50; P = 0.011]). The proportion with overlooked neoplasms was lower in the LCI group than in the WLI group (5 of 750 patients or 0.67% [CI, 0.2% to 1.6%] vs. 26 of 752 patients or 3.5% [CI, 2.3% to 5.0%]; risk ratio, 0.19 [CI, 0.07 to 0.50]).

Limitation:
Endoscopists were not blinded.

Conclusion:
LCI is more effective than WLI for detecting neoplastic lesions in the pharynx, esophagus, and stomach.

Primary Funding Source:
Fujifilm Corporation.

Journal Article

JOURNAL:
Annals of Internal Medicine

TITLE:
Linked Color Imaging Focused on Imaging for Neoplasm Detection in Upper Gastrointestinal Tract. A Randomized Trial

DOI:
https://doi.org/10.7326/M19-2561

Correspondence to

KAWADA Kenro, Junior Associate Professor
Department of Gastrointestinal Surgery,
Graduate School of Medical and Dental Sciences,
Tokyo Medical and Dental University(TMDU)
E-mail:kawada.srg1(at)tmd.ac.jp


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