-Original-

Comparison of Linked Color Imaging and White Light Imaging Colonoscopy for Detection of Colorectal Adenoma Requiring Endoscopic Treatment: A Single-Center Randomized Controlled Trial

Shu Tanaka¹, Jun Omori², Aitoshi Hoshimoto², Takayoshi Nishimoto², Naohiko Akimoto², Atsushi Tatsuguchi², Shunji Fujimori³ and Katsuhiko Iwakiri²

¹Department of Gastroenterology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
²Department of Gastroenterology, Nippon Medical School Hospital, Tokyo, Japan
³Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Background: Linked color imaging (LCI) improves detection of colorectal neoplastic lesions during colonoscopy. However, polyps <5 mm in diameter often do not require resection, and the benefits of LCI are unclear for detection of colorectal polyps ?5 mm that are indicated for endoscopic resection in clinical practice. This randomized controlled trial compared rates of detection of adenoma polyps, stratified by size, for LCI and white light imaging (WLI).
Methods: We compared ADR(5 mm-) and PDR(5 mm-), which were defined as the proportion of patients with at least one adenoma or polyp with a diameter of 5 mm or larger in the LCI and WLI groups. Moreover, we estimated ADR and PDR for diameters between 5 and 10 mm (ADR(5-9 mm), PDR(5-9 mm)) and for diameters larger than 10 mm (ADR(10 mm-), PDR(10 mm-)).
Results: Data from 594 patients (LCI, n=305; WLI, n=289) were analyzed. ADR(5 mm-) and PDR(5 mm-) were significantly higher in the LCI group than in the WLI group (ADR(5 mm-): P=0.016, PDR(5 mm-): P=0.020). In the assessment of adenoma and polyp size, ADR(5-9 mm) and PDR(5-9 mm) were significantly higher in the LCI group than in the WLI group, although no significant differences were seen in ADR(10 mm-) and PDR(10 mm-) between these groups.
Conclusions: Polyps ?5 mm, which are indicated for endoscopic treatment, were more easily visualized with LCI mode than with WLI mode. The improvement in detection rate was obvious for polyps <10 mm, which are easier to miss.

J Nippon Med Sch 2023; 90: 111-120

Keywords
linked color image, adenoma detection rate, polyp detection rate, 5 mm, colonoscopy

Correspondence to
Shu Tanaka, MD, PhD, Department of Gastroenterology, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
tanashu@nms.ac.jp

Received, August 24, 2022
Accepted, November 10, 2022