Linked color imaging improves polyp miss rates in total colonoscopy in a multicenter randomized back to back trial

Linked color imaging (LCI) was developed to detect gastrointestinal neoplasms. The current study aimed to determine whether the use of LCI, compared with white-light imaging (WLI), can improve the miss rates of colorectal polyp. A multicenter, randomized back-to-back study was conducted in 16 Japanese endoscopy units. Patients were randomized according to examination: tandem colonoscopy with WLI followed by LCI (WLI-LCI group) and with LCI followed by WLI (LCI-WLI group). The detected polyps were evaluated according to location, size, morphology, and histopathological diagnosis. The primary outcome was polyp miss rate per patient (PMR-PP) in total colonoscopy. The secondary outcome was adenoma detection rate (ADR) during the first assessment in each group. The full analysis set comprised 327 participants, and 320 were included in either two groups. The PMR-PPs were 9.3% and 20.6% in the LCI-WLI and WLI-LCI groups, respectively. Regarding location, the PMR-PP of LCI was significantly lower than that of WLI in the transverse and descending colons and rectum. In terms of diminutive adenomas (< 5 mm), the ADR of LCI (38.2%) was significantly higher than that of WLI (29.1%). LCI was superior to WLI in terms of polyp miss rate particularly in the transverse and descending colons and rectum.

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Journal
Scientific Reports
Published
2025-10-21
DOI
https://doi.org/10.1038/s41598-025-20633-2
Primary Topic
Colorectal Cancer Screening and Detection
Type
article
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article

Linked color imaging improves polyp miss rates in total colonoscopy in a multicenter randomized back to back trial

Yorinobu Sumida, Masayuki Kabayama, Shimpei Shirai, Fumiaki Kiyomi et al.
Scientific Reports
Colorectal Cancer Screening and Detection
article

Linked color imaging improves polyp miss rates in total colonoscopy in a multicenter randomized back to back trial

Yorinobu Sumida, Masayuki Kabayama, Shimpei Shirai, Fumiaki Kiyomi, Tomohiko Moriyama, Tetsu Kinjo, Koichi Miyahara, Kazutoshi Hashiguchi, Tadashi Miike, Kazuhiro Mizukami, Daisuke Yamaguchi, Ryo Shimoda, Naoyuki Yamaguchi, Kensei Ohtsu, Tetsuya Ohira, Keiichi Hashiguchi, Hideaki Miyamoto, Takashi Akutagawa, Ryosuke Gushima, Ken Ohnita, Shin Fujioka, Fumisato Sasaki, Sho Suzuki, T. SHONO, Akira Aso, K Fukuda, Tetsuro Honda
article en

Abstract

Linked color imaging (LCI) was developed to detect gastrointestinal neoplasms. The current study aimed to determine whether the use of LCI, compared with white-light imaging (WLI), can improve the miss rates of colorectal polyp. A multicenter, randomized back-to-back study was conducted in 16 Japanese endoscopy units. Patients were randomized according to examination: tandem colonoscopy with WLI followed by LCI (WLI-LCI group) and with LCI followed by WLI (LCI-WLI group). The detected polyps were evaluated according to location, size, morphology, and histopathological diagnosis. The primary outcome was polyp miss rate per patient (PMR-PP) in total colonoscopy. The secondary outcome was adenoma detection rate (ADR) during the first assessment in each group. The full analysis set comprised 327 participants, and 320 were included in either two groups. The PMR-PPs were 9.3% and 20.6% in the LCI-WLI and WLI-LCI groups, respectively. Regarding location, the PMR-PP of LCI was significantly lower than that of WLI in the transverse and descending colons and rectum. In terms of diminutive adenomas (< 5 mm), the ADR of LCI (38.2%) was significantly higher than that of WLI (29.1%). LCI was superior to WLI in terms of polyp miss rate particularly in the transverse and descending colons and rectum.

Scientific ReportsVol. 15(1)
Kagoshima University (JP), Kyushu University (JP), Saga University (JP), Oita University (JP), National Kyushu Medical Center (JP), Fukuoka University (JP), Inoue Hospital (JP), Kyushu Economic Research Center (JP), Takamatsu Red Cross Hospital (JP), Saiseikai Kumamoto Hospital (JP), Nagasaki Medical Center (JP), Kumamoto University Hospital (JP), Imamura Hospital (JP), Ono Clinic (JP), University of Miyazaki Hospital (JP), Saiseikai Nakatsu Hospital (JP), National Hospital Organization (JP), Ureshino Medical Center (JP), University of the Ryukyus University Hospital (JP), Nagasaki University Hospital (JP)
Openalex Percentile: Top 60%
Colorectal Cancer Screening and Detection
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