Yoshida Naohisa, Draganov Peter V, John Sneha, Neumann Helmut, Rani Rafiz Abdul, Hsu Wen-Hsin, Fernandopulle Nilesh, Siah Kewin Tien Ho, Morgenstern Ricardo, Tomita Yuri, Inoue Ken, Dohi Osamu, Hirose Ryohei, Itoh Yoshito, Murakami Takaaki, Inagaki Yoshikazu, Inada Yutaka, Arantes Vitor
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
Endoscopy Department, University of Florida, Gainesville, FL, USA.
Dig Dis Sci. 2023 Oct;68(10):3943-3952. doi: 10.1007/s10620-023-08057-2. Epub 2023 Aug 9.
In light-emitting diode (LED) and LASER colonoscopy, linked color imaging (LCI) and blue light/laser imaging (BLI) are used for lesion detection and characterization worldwide. We analyzed the difference of LCI and BLI images of colorectal lesions between LED and LASER in a multinational study.
We prospectively observed lesions with white light imaging (WLI), LCI, and BLI using both LED and LASER colonoscopies from January 2020 to August 2021. Images were graded by 27 endoscopists from nine countries using the polyp visibility score: 4 (excellent), 3 (good), 2 (fair), and 1 (poor) and the comparison score (LED better/similar/LASER better) for WLI/LCI/BLI images of each lesion.
Finally, 32 lesions (polyp size: 20.0 ± 15.2 mm) including 9 serrated lesions, 13 adenomas, and 10 T1 cancers were evaluated. The polyp visibility scores of LCI/WLI for international and Japan-expert endoscopists were 3.17 ± 0.73/3.17 ± 0.79 (p = 0.92) and 3.34 ± 0.78/2.84 ± 1.22 (p < 0.01) for LED and 3.30 ± 0.71/3.12 ± 0.77 (p < 0.01) and 3.31 ± 0.82/2.78 ± 1.23 (p < 0.01) for LASER. Regarding the comparison of lesion visibility about between LED and LASER colonoscopy in international endoscopists, a significant difference was achieved not for WLI, but for LCI. The rates of LED better/similar/LASER better for brightness under WLI were 54.5%/31.6%/13.9% (International) and 75.0%/21.9%/3.1% (Japan expert). Those under LCI were 39.2%/35.4%/25.3% (International) and 31.3%/53.1%/15.6% (Japan expert). There were no significant differences in the diagnostic accuracy and the comparison score of BLI images between LED and LASER.
The differences of lesion visibility for WLI/LCI/BLI between LED and LASER in international endoscopists could be compared to those in Japanese endoscopists.
在发光二极管（LED）和激光结肠镜检查中，联动成像（LCI）和蓝光/激光成像（BLI）在全球范围内用于病变检测和特征描述。我们在一项跨国研究中分析了LED和激光在大肠病变的LCI和BLI图像上的差异。
我们前瞻性地观察了2020年1月至2021年8月使用LED和激光结肠镜进行白光成像（WLI）、LCI和BLI的病变。来自9个国家的27名内镜医师使用息肉可见度评分：4（优秀）、3（良好）、2（一般）和1（差）以及每个病变的WLI/LCI/BLI图像的比较评分（LED更好/相似/激光更好）对图像进行分级。
最终评估了32个病变（息肉大小：20.0±15.2mm），包括9个锯齿状病变、13个腺瘤和10个T1期癌。国际和日本专家内镜医师的LCI/WLI息肉可见度评分，LED分别为3.17±0.73/3.17±0.79（p = 0.92）和3.34±0.78/2.84±1.22（p < 0.01），激光分别为3.30±0.71/3.12±0.77（p < 0.01）和3.31±0.82/2.78±1.23（p < 0.01）。关于国际内镜医师中LED和激光结肠镜检查在病变可见度方面的比较，WLI未发现显著差异，但LCI有显著差异。WLI下LED更好/相似/激光更好的比例在国际上为54.5%/31.6%/13.9%，在日本专家中为75.0%/21.9%/3.1%。LCI下的比例在国际上为39.2%/35.4%/25.3%，在日本专家中为31.3%/53.1%/15.6%。LED和激光在BLI图像的诊断准确性和比较评分方面没有显著差异。
国际内镜医师中LED和激光在WLI/LCI/BLI病变可见度上的差异与日本内镜医师的情况相似。
