Linked color imaging endoscopy improved detection of upper GI cancers
An industry-funded trial in Japan found that in high-risk adults, linked color imaging endoscopy improved detection of upper GI neoplasms compared with conventional white light imaging.
Linked color imaging, a new image-enhanced endoscopy technique that allows users to recognize slight differences in mucosal color, improved the detection of upper GI neoplasms compared with white light imaging in a recent industry-funded trial.
Researchers in Japan randomized participants to receive either white light imaging followed by linked color imaging examination (white light group) or linked color imaging followed by white light imaging examination (linked color group). The trial included 1,502 patients with known previous or current cancer of the GI tract who were undergoing surveillance for GI cancer at 16 university hospitals and three tertiary care hospitals. The primary outcome was diagnosis of one or more neoplastic lesions in the pharynx, esophagus, or stomach in the first examination. The secondary outcome was the proportion of participants with overlooked neoplastic lesions in the first examination. Fujifilm Corporation provided financial support and all medical equipment to the participating institutions but was not involved in designing the study, handling the results, or preparing the manuscript. Results were published online on Oct. 20 by Annals of Internal Medicine.
Seven hundred fifty-two patients were assigned to the white light group and 750 to the linked color group. The percentage of patients with one or more neoplastic lesions diagnosed in the first examination was higher with linked color imaging than with white light imaging (60 of 750 patients [8.0%; 95% CI, 6.2% to 10.2%] vs. 36 of 752 patients [4.8%; 95% CI, 3.4% to 6.6%]; risk ratio, 1.67 [95% CI, 1.12 to 2.50]; P=0.011). The proportion of participants with overlooked neoplasms was lower in the linked color group than in the white light group (5 of 750 patients [0.67%; 95% CI, 0.2% to 1.6%] vs. 26 of 752 patients [3.5%; 95% CI, 2.3% to 5.0%]; risk ratio, 0.19 [95% CI, 0.07 to 0.50]; P<0.001).
Limitations of the study include the fact that endoscopists were not blinded to group allocation, the authors noted. They added that the examinations were performed by experts in upper GI endoscopy and therefore the results could be different if performed by general clinicians on an average population. The authors concluded that linked color imaging “should be recommended in screening for upper GI tract cancer” in high-risk patients, although further investigation in the general population is needed.