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Blue laser imaging and linked color imaging improve the color difference value and visibility of colorectal polyps in underwater conditions
Author(s) -
Yamasaki Yasushi,
Harada Keita,
Yamamoto Shumpei,
Yasutomi Eriko,
Okanoue Shotaro,
Hirai Mami,
Oka Shohei,
Obayashi Yuka,
Sakae Hiroyuki,
Hamada Kenta,
Inokuchi Toshihiro,
Kinugasa Hideaki,
Sugihara Yuusaku,
Takahara Masahiro,
Tanaka Takehiro,
Hiraoka Sakiko,
Kawahara Yoshiro,
Okada Hiroyuki
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13581
Subject(s) - medicine , colorectal polyp , visibility , white light , nuclear medicine , colorectal cancer , colonoscopy , optics , cancer , physics
Background and Aim Underwater endoscopic mucosal resection (UEMR) has become widespread for treating colorectal polyps. However, which observational mode is best suited for determining polyp margins underwater remains unclear. To determine the best mode, we analyzed three imaging modes: white light imaging (WLI), blue laser imaging (BLI) and linked color imaging (LCI). Methods Images of consecutive colorectal polyps previously examined by these three modes before UEMR were analyzed according to the degree of underwater turbidity (transparent or cloudy). Color differences between the polyps and their surroundings were calculated using the Commission Internationale d’Eclairage Lab color space in which 3‐D color parameters were expressed. Eight evaluators, who were blinded to the histology, scored the visibility from one (undetectable) to four (easily detectable) in both underwater conditions. The color differences and visibility scores were compared. Results Seventy‐three polyps were evaluated. Sixty‐one polyps (44 adenomatous, 17 serrated) were observed under transparent conditions, and 12 polyps (seven adenomatous, five serrated) were observed under cloudy conditions. Under transparent conditions, color differences for the BLI (8.5) and LCI (7.9) were significantly higher than that of WLI (5.7; P < 0.001). Visibility scores for BLI (3.6) and LCI (3.4) were also higher than that of WLI (3.1; P < 0.0001). Under cloudy conditions, visibility scores for LCI (2.9) and WLI (2.7) were significantly higher than that of BLI (2.2; P < 0.0001 and P = 0.04, respectively). Conclusions BLI and LCI were better observational modes in transparent water; however, BLI was unsuitable for cloudy conditions.