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- Title
Linked Color Imaging Focused on Neoplasm Detection in the Upper Gastrointestinal Tract : A Randomized Trial.
- Authors
Ono, Shoko; Kawada, Kenro; Dohi, Osamu; Kitamura, Shinji; Koike, Tomoyuki; Hori, Shinichiro; Kanzaki, Hiromitsu; Murao, Takahisa; Yagi, Nobuaki; Sasaki, Fumisato; Hashiguchi, Keiichi; Oka, Shiro; Katada, Kazuhiro; Shimoda, Ryo; Mizukami, Kazuhiro; Suehiro, Mitsuhiko; Takeuchi, Toshihisa; Katsuki, Shinichi; Tsuda, Momoko; Naito, Yuji
- Abstract
<bold>Background: </bold>Linked color imaging (LCI) is a new image-enhanced endoscopy technique that allows users to recognize slight differences in mucosal color.<bold>Objective: </bold>To compare the performance of LCI with white light imaging (WLI) in detecting neoplastic lesions in the upper gastrointestinal tract.<bold>Design: </bold>A controlled, multicenter trial with randomization using minimization. (University Hospital Medical Information Network Clinical Trials Registry: UMIN000023863).<bold>Setting: </bold>16 university hospitals and 3 tertiary care hospitals in Japan.<bold>Patients: </bold>1502 patients with known previous or current cancer of the gastrointestinal tract and undergoing surveillance for gastrointestinal cancer.<bold>Intervention: </bold>WLI followed by LCI examination (WLI group) or LCI followed by WLI examination (LCI group).<bold>Measurements: </bold>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).<bold>Results: </bold>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]).<bold>Limitation: </bold>Endoscopists were not blinded.<bold>Conclusion: </bold>LCI is more effective than WLI for detecting neoplastic lesions in the pharynx, esophagus, and stomach.<bold>Primary Funding Source: </bold>Fujifilm Corporation.
- Subjects
GASTROINTESTINAL system; RESEARCH; RESEARCH evaluation; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; GASTROINTESTINAL tumors; DIAGNOSTIC imaging; COMPARATIVE studies; ENDOSCOPIC gastrointestinal surgery
- Publication
Annals of Internal Medicine, 2021, Vol 174, Issue 1, p18
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/M19-2561