Su1138 INVESTIGATION OF THE USEFULNESS OF LINKED COLOR IMAGING (LCI) IN BARRETT'S ESOPHAGUS DIAGNOSIS

Linked color imaging (LCI), a new image-enhanced endoscopic approach, has been reported to be useful for surveillance of the colon and stomach. However, the extent of its contribution to the diagnosis of Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC) is unclear. This study aimed to evaluate the usefulness of LCI in the diagnosis of BE and EAC. We prospectively evaluated 40 cases of BE (including four cases of EAC). Initially, the visibility of BE was evaluated with visibility scores (1–4) by three trainees and three experts using white light imaging (WLI), LCI, and blue laser imaging bright (BLI-b) modes. In addition, gray values (luminance) of BE were calculated using an image processing software (ImageJ, NIH, Bethesda, MD, USA). Then, pathological examinations (presence of intestinal-type goblet cells, presence of dysplasia, and degree of inflammation) of BE were performed in all cases. The visibility scores of BE were significantly higher with the LCI mode than with the WLI and BLI-b modes in both trainees and experts (trainees: WLI 2.95 ± 1.08, LCI 3.54 ± 0.56, and BLI-b 1.96 ± 0.60; experts: 2.94 ± 0.96, 3.62 ± 0.57, and 2.99 ± 0.88). The gray values were also significantly higher with the LCI mode than with the other modes (WLI 92.6 ± 21.4, LCI 103.8 ± 27.3, and BLI-b 64.0 ± 30.3). Pathologically, the probabilities of moderate or severe inflammation and/or EAC were significantly higher at the sites where palisade vessels were not recognized than at the sites where palisade vessels were recognized. There was no statistically significant difference between the presence or absence of palisade vessels and the presence of intestinal goblet cells. We also evaluated the visibility of EAC; however, no statistically significant differences were observed among the imaging modes. LCI increases brightness for the evaluation of BE and improves the visibility of BE. There is a high probability of moderate or severe inflammation and EAC at BE sites without palisade vessels.