Improved Visibility of Barrett's Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis - PubMed (original) (raw)

Comparative Study

doi: 10.1159/000485459. Epub 2018 Jan 10.

Akihito Nagahara 2, Kei Ishizuka 1, Shoki Okubo 1, Keiichi Haga 1, Maiko Suzuki 1, Akihito Nakajima 1, Hiroyuki Komori 1, Yoichi Akazawa 1, Kentaro Izumi 1, Kohei Matsumoto 1, Hiroya Ueyama 1, Yuji Shimada 2, Kenshi Matsumoto 1, Daisuke Asaoka 1, Tomoyoshi Shibuya 1, Naoto Sakamoto 1, Taro Osada 1, Mariko Hojo 1, Shuko Nojiri 3, Sumio Watanabe 1

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Comparative Study

Improved Visibility of Barrett's Esophagus with Linked Color Imaging: Inter- and Intra-Rater Reliability and Quantitative Analysis

Tsutomu Takeda et al. Digestion. 2018.

Abstract

Background/aims: To evaluate the usefulness of linked color imaging (LCI) and blue LASER imaging (BLI) in Barrett's esophagus (BE) compared with white light imaging (WLI).

Methods: Five expert and trainee endoscopists compared WLI, LCI, and BLI images obtained from 63 patients with short-segment BE. Physicians assessed visibility as follows: 5 (improved), 4 (somewhat improved), 3 (equivalent), 2 (somewhat decreased), and one (decreased). Scores were evaluated to assess visibility. The inter- and intra-rater reliability (intra-class correlation coefficient) of image assessments were also evaluated. Images were objectively evaluated based on L* a* b* color values and color differences (ΔE*) in a CIELAB color space system.

Results: Improved visibility compared with WLI was achieved for LCI: 44.4%, BLI: 0% for all endoscopists; LCI: 55.6%, BLI: 1.6% for trainees; and LCI: 47.6%, BLI: 0% for experts. The visibility score of trainees compared with experts was significantly higher for LCI (p = 0.02). Intra- and inter-rater reliability ratings for LCI compared with WLI were "moderate" for trainees, and "moderate-substantial" for experts. The ΔE* revealed statistically significant differences between WLI and LCI.

Conclusion: LCI improved the visibility of short-segment BE compared with WLI, especially for trainees, when evaluated both subjectively and objectively.

Keywords: Barrett’s esophagus; Blue LASER imaging; Inter- and intra-rater reliability; Intra-class correlation coefficient; Linked color imaging.

© 2018 S. Karger AG, Basel.

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