Volume 23, Issue 6 pp. 1414-1420
ORIGINAL ARTICLE

Linked colour imaging versus white-light colonoscopy for the detection of flat colorectal lesions: A randomized controlled trial

Takahiro Kudo

Takahiro Kudo

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan

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Akira Horiuchi

Corresponding Author

Akira Horiuchi

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

Correspondence

Akira Horiuchi, Digestive Disease Center, Showa Inan General Hospital, 3230 Akaho, Komagane 399-4117, Japan.

Email: [email protected]

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Reiko Kyodo

Reiko Kyodo

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan

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Ichitaro Horiuchi

Ichitaro Horiuchi

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

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Nobuyasu Arai

Nobuyasu Arai

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan

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Masashi Kajiyama

Masashi Kajiyama

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

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Naoki Tanaka

Naoki Tanaka

Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan

Department of Metabolic Regulation, Shinshu University School of Medicine, Matsumoto, Japan

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First published: 01 March 2021
Citations: 11

The study was registered at www.clinicaltrials.gov (NCT NCT03272945) on 2 September 2017.

Abstract

Aim

Linked colour imaging is an image-enhanced endoscopy system that emphasizes the red portion of the mucosa's colour. Our aim was to compare the effectiveness of linked colour imaging with white-light colonoscopy for the detection of flat-type colorectal polyps.

Method

This was a single-centre, randomized controlled trial. Enrolled patients were those aged ≥50 years undergoing cap-assisted colonoscopy for colorectal cancer screening. They were randomized in a 1:1 ratio for observation using linked colour imaging or white-light colonoscopy. All colorectal polyps detected were removed or biopsied. The primary outcome was the number of flat-type polyps per patient in patients in whom flat polyps were detected. Secondary outcomes included adenoma and polyp detection rates.

Results

There were 302 subjects randomized: 152 to linked colour imaging and 150 to white-light colonoscopy. There were no differences in the clinical features between the two arms. The number of flat polyps detected per patient using linked colour imaging was approximately twice that with white light (2.9 ± 3.0 vs 1.2 ± 1.6, p = 0.045). Linked colour imaging also proved superior to white-light colonoscopy in terms of adenoma and polyp detection rates [adenomas 66% (101/152) vs 49% (73/150), p = 0.0024; polyps 69% (105/152) vs 55% (82/150), p = 0.013]. The ratio of polyps detected in the right colon compared with those detected in the left colon was significantly greater using linked colour than white-light imaging (168/64 vs 93/84; p < 0.001).

Conclusion

Compared with white-light colonoscopy, linked colour imaging improved adenoma and polyp detection rates, including detection of flat-type colorectal polyps.

CONFLICT OF INTERESTS

The authors declare no conflicts of interest for this article.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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