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

Dig Dis Sci

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.

Published: June 2022

A study in Japan compared the visibility of early gastric cancers (EGCs) and H. pylori-associated gastritis using LED endoscopy versus the traditional laser endoscopy.
The study evaluated 99 lesions and found that the visibility scores for both types of endoscopy showed non-inferiority, indicating LED endoscopy works comparably well to laser techniques.
Additionally, linked color imaging (LCI) proved to be more effective than white-light imaging (WLI) for both EGCs and gastritis, making LED endoscopy a viable option for accurate detection.

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.

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http://dx.doi.org/10.1007/s10620-021-07234-5	DOI Listing

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