Linked-color imaging versus narrow-band imaging for colorectal polyp detection: a prospective randomized tandem colonoscopy study.

Abstract

BACKGROUND AND AIMS\nLinked-color imaging (LCI) is a newly available image enhanced endoscopy (IEE) system, which emphasizes the red mucosal color. No study has yet compared LCI with other available IEE systems.\n\n\nAIM\nTo compare the polyp detection rates of LCI with narrow band imaging (NBI).\n\n\nMETHODS\nThis is a prospective randomized tandem colonoscopy study. Eligible patients who underwent colonoscopy for symptoms or screening/surveillance were randomized in a 1:1 ratio to receive tandem colonoscopy with both colonoscope withdrawals using LCI or NBI. The primary outcome was polyp detection rate.\n\n\nRESULTS\nTwo hundred seventy-two patients were randomized (mean age 62 years; 48.2% male; colonoscopy for symptoms: 72.8%) with 136 in each arm. During first colonoscopy, the NBI group had significantly higher polyp detection rate (71.3% vs 55.9%; P = 0.008), serrated lesion detection rate (34.6% vs 22.1%; P = 0.02), and mean number of polyps detected (2.04 vs 1.35; P = 0.02) than the LCI group. There was also a trend of higher adenoma detection rate in the NBI group (51.5% vs 39.7% in LCI; P = 0.05). Multivariable analysis confirmed that use of NBI (adjusted OR, 1.99; 95% CI, 1.09-3.68) and withdrawal time >8 minutes (aOR, 5.11; 95% CI, 2.79-9.67) were associated with polyp detection. Overall, 20.5% of polyps and 18.1% of adenoma were missed by first colonoscopy, but there was no significant difference in the miss rates between the 2 groups.\n\n\nCONCLUSION\nNBI was significantly better than LCI for colorectal polyp detection. However, both LCI and NBI missed 20.5% of polyps.