Enhanced Visibility in Evaluating Gastric Cancer and Helicobacter pylori-Associated Gastritis Using Linked Color Imaging with a Light-Emitting Diode Light Source

Tsugitaka Ishida; Osamu Dohi; Naohisa Yoshida; Takeshi Yasuda; Takuma Yoshida; Yuka Azuma; Hiroaki Kitae; Shinya Matsumura; Toshifumi Doi; Ryohei Hirose; Ken Inoue; Kazuhiro Kamada; Kazuhiko Uchiyama; Takeshi Ishikawa; Tomohisa Takagi; Hideyuki Konishi; Yuji Naito; Yoshito Itoh

doi:10.1007/s10620-021-07234-5

Enhanced Visibility in Evaluating Gastric Cancer and Helicobacter pylori-Associated Gastritis Using Linked Color Imaging with a Light-Emitting Diode Light Source

Dig Dis Sci. 2022 Jun;67(6):2367-2374. doi: 10.1007/s10620-021-07234-5. Epub 2021 Aug 31.

Authors

Tsugitaka Ishida¹, Osamu Dohi², Naohisa Yoshida¹, Takeshi Yasuda¹, Takuma Yoshida¹, Yuka Azuma¹, Hiroaki Kitae¹, Shinya Matsumura¹, Toshifumi Doi¹, Ryohei Hirose¹, Ken Inoue¹, Kazuhiro Kamada¹, Kazuhiko Uchiyama¹, Takeshi Ishikawa¹, Tomohisa Takagi¹, Hideyuki Konishi¹, Yuji Naito¹, Yoshito Itoh¹

Affiliations

¹ Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji Kamigyo-ku, Kyoto, 602-8566, Japan.
² Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi Hirokoji Kamigyo-ku, Kyoto, 602-8566, Japan. osamu-d@koto.kpu-m.ac.jp.

PMID: 34463884
DOI: 10.1007/s10620-021-07234-5

Abstract

Background: In Japan, laser light source (Laser) endoscopy is widely available, and the characteristics of light-emitting diode light source (LED) endoscopy have not been clarified.

Aims: We assessed the visibility of early gastric cancers (EGCs) and Helicobacter pylori (H. pylori)-associated gastritis for LED endoscopy compared with laser endoscopy using white-light imaging (WLI) and linked color imaging (LCI).

Methods: We assessed 99 lesions between February 2019 and March 2020. The visibility was scored from four (excellent visibility) to one (poor visibility) by evaluating videos including EGCs and gastric mucosa captured using WLI and LCI with LED endoscopy (LED-WLI and LED-LCI, respectively) and laser endoscopy (Laser-WLI and Laser-LCI, respectively). The primary end point was the non-inferiority of the visibility of EGCs and H. pylori-associated gastritis between LED-/Laser-WLI and LED-/Laser-LCI.

Results: The visibility scores of EGCs for LED-/Laser-WLI and LED-/Laser-LCI were 3.14/2.97 and 3.39/3.35, respectively. The visibility scores of H. pylori-associated gastritis [intestinal metaplasia (IM), diffuse redness (DR), regular arrangement of collecting venules (RAC) and map-like redness (MR)] for LED-/Laser-WLI and LED-/Laser-LCI were 3.05/2.85 and 3.60/3.50 (IM), 2.76/2.50 and 2.96/2.86 (DR), 2.69/2.44 and 2.77/2.62 (RAC) and 2.97/2.75 and 3.39/3.27 (MR). Non-inferiority was demonstrated for visualizing EGCs and H. pylori-associated gastritis.

Conclusions: LED-WLI and LED-LCI can be used to visualize EGCs and H. pylori-associated gastritis with non-inferiority to Laser-WLI and Laser-LCI. Furthermore, even with LED, LCI was more effective than WLI for evaluating EGCs and H. pylori-associated gastritis. Therefore, LED endoscopy can be used to detect EGCs and evaluate H. pylori-associated gastritis accurately.

Keywords: Early gastric cancer; Kyoto classification; Light-emitting diode; Linked color imaging; Visibility.

MeSH terms

Color
Gastritis* / pathology
Helicobacter Infections* / diagnostic imaging
Helicobacter pylori*
Humans
Intraabdominal Infections*
Metaplasia / diagnostic imaging
Stomach Neoplasms* / diagnostic imaging
Stomach Neoplasms* / pathology