Comparison of linked color imaging and white-light colonoscopy for detection of colorectal polyps: a multicenter, randomized, crossover trial

  • Author Footnotes
    ∗ Drs Min and Deng contributed equally to this work.
    Min Min
    Footnotes
    ∗ Drs Min and Deng contributed equally to this work.
    Affiliations
    Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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  • Author Footnotes
    ∗ Drs Min and Deng contributed equally to this work.
    Pei Deng
    Footnotes
    ∗ Drs Min and Deng contributed equally to this work.
    Affiliations
    Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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  • Wenhua Zhang
    Affiliations
    Department of Gastroenterology and Hepatology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nan Ning, Guangxi, China
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  • Xiaomin Sun
    Affiliations
    Department of Gastroenterology and Hepatology, Shanghai Tenth People’s Hospital, Shanghai, 200000, China
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  • Yan Liu
    Correspondence
    Reprint requests: Professor Yan Liu, Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
    Affiliations
    Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
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  • Bing Nong
    Correspondence
    Professor Bing Nong, Department of Gastroenterology and Hepatology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530000, China.
    Affiliations
    Department of Gastroenterology and Hepatology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nan Ning, Guangxi, China
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  • Author Footnotes
    ∗ Drs Min and Deng contributed equally to this work.
Published:March 09, 2017DOI:https://doi.org/10.1016/j.gie.2017.02.035

      Background and Aims

      Linked color imaging (LCI), a recently developed technology, uses a laser endoscopic system to enhance the color separation of red color to depict red and white colors more vividly. The benefits of LCI in the detection of colorectal polyps remain unknown. The aim of this study was to assess the ability of LCI to improve the detection of colorectal polyps compared with white-light (WL) endoscopy.

      Methods

      We performed a multicenter, crossover, prospective, randomized controlled trial in 3 hospitals in China. All patients underwent crossover colonoscopies with LCI and WL endoscopy in a randomized order. All lesions were removed during the second endoscopic procedure. The primary outcome measure was the difference in sensitivity between LCI and WL endoscopy for the detection of colorectal polyps. The secondary outcome measures were the adenoma detection rate per patient in the 2 groups and the factors associated with polyp miss rates.

      Results

      A total of 152 patients were randomized, and 141 were included in the analysis. The overall polyp detection rate increased significantly by 24% for LCI colonoscopy, corresponding to a higher sensitivity with LCI than with WL endoscopy (91% vs 73%, P < .0001). Furthermore, LCI identified significantly more patients (32%) with polyps. The per-patient adenoma detection rate was significantly higher for LCI than for WL endoscopy (37% vs 28%; 95% confidence interval, 2.39%-19.41%).

      Conclusions

      LCI improves the detection of colorectal polyps and adenomas during colonoscopy. (Clinical trial registration number: NCT02724397.)

      Abbreviations:

      BBPS (Boston Bowel Preparation Scale), BLI (blue laser image), CRC (colorectal cancer), IEE (image-enhanced endoscopic), LCI (linked color imaging), NBI (narrow-band imaging), WL (white light)
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