ArticleBMC gastroenterology2020
Linked color imaging improves visibility of reflux esophagitis.
Article in BMC gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Texture and Color Enhancement Imaging for the Kyoto Classification of Gastritis: Evaluation of Visibility and Color Differences.DEN open · 2026Article
- Review
- Future of image enhanced endoscopy of esophageal adenocarcinoma.Clinical endoscopy · 2025Review
- Development of an Artificial Intelligence Diagnostic System Using Linked Color Imaging for Barrett's Esophagus.Journal of clinical medicine · 2024Article
- Risk Factors for Mucosal Redness in the Duodenal Bulb as Detected via Linked Color Imaging.Diagnostics (Basel, Switzerland) · 2024Article
- Role of endoscopy in gastroesophageal reflux disease.Clinical endoscopy · 2023Review
- Role of linked color imaging for upper gastrointestinal disease: present and future.Clinical endoscopy · 2023Review
- Comparison of Texture and Color Enhancement Imaging with White Light Imaging in 52 Patients with Short-Segment Barrett's Esophagus.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Article
- Usefulness of Endoscopy for the Detection and Diagnosis of Primary Esophageal Motility Disorders and Diseases Relating to Abnormal Esophageal Motility.Diagnostics (Basel, Switzerland) · 2023Review
- Endoscopic Diagnosis of Eosinophilic Esophagitis: Basics and Recent Advances.Diagnostics (Basel, Switzerland) · 2022Review
- Review
- Predictive value of risk score using Kyoto classification of gastritis a few years prior to diagnosis of early gastric cancer.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review.Therapeutic advances in gastroenterology · 2021Article
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith more prevalent gastroesophageal reflux disease comes increased cases of Barrett's esophagus and esophageal adenocarcinoma. Image-enhanced endoscopy using linked-color imaging (LCI) differentiates between mucosal colors. We compared LCI, white light imaging (WLI), and blue LASER imaging (BLI) in diagnosing reflux esophagitis (RE).
methodsConsecutive RE patients (modified Los Angeles [LA] classification system) who underwent esophagogastroduodenoscopy using WLI, LCI, and BLI between April 2017 and March 2019 were selected retrospectively. Ten endoscopists compared WLI with LCI or BLI using 142 images from 142 patients. Visibility changes were scored by endoscopists as follows: 5, improved; 4, somewhat improved; 3, equivalent; 2, somewhat decreased; and 1, decreased. For total scores, 40 points was considered improved visibility, 21-39 points was comparable to white light, and < 20 points equaled decreased visibility. Inter- and intra-rater reliabilities (Intra-class Correlation Coefficient [ICC]) were also evaluated. Images showing color differences (ΔE*) and L* a* b* color values in RE and adjacent esophageal mucosae were assessed using CIELAB, a color space system.
resultsThe mean age of patients was 67.1 years (range: 27-89; 63 males, 79 females). RE LA grades observed included 52 M, 52 A, 24 B, 11 C, and 3 D. Compared with WLI, all RE cases showed improved visibility: 28.2% (40/142), LA grade M: 19.2% (10/52), LA grade A: 34.6% (18/52), LA grade B: 37.5% (9/24), LA grade C: 27.3% (3/11), and LA grade D: 0% (0/3) in LCI, and for all RE cases: 0% in BLI. LCI was not associated with decreased visibility. The LCI inter-rater reliability was "moderate" for LA grade M and "substantial" for erosive RE. The LCI intra-rater reliability was "moderate-substantial" for trainees and experts. Color differences were WLI: 12.3, LCI: 22.7 in LA grade M; and WLI: 18.2, LCI: 31.9 in erosive RE (P < 0.001 for WLI vs. LCI).
conclusionLCI versus WLI and BLI led to improved visibility for RE after subjective and objective evaluations. Visibility and the ICC for minimal change esophagitis were lower than for erosive RE for LCI. With LCI, RE images contrasting better with the surrounding esophageal mucosa were more clearly viewed.
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