Surveillance Colonoscopy With Linked-Color Imaging Increases Adenoma Detection Rate Compared With White-Light Imaging

Colonoscopies using linked-color imaging were more effective at detecting adenomas compared with white-light imaging.

Colonoscopies using linked-color imaging (LCI) were more effective at detecting adenomas compared with white-light imaging, according to results of a prospective randomized study published in the Journal of Clinical Gastroenterology.

Individuals (N=205) undergoing colonoscopy screening at a single center in Brazil between July and December 2020 were randomly assigned to undergo imaging with LCI (n=69), white-light imaging (WLI; n=70), or blue-laser imaging (BLI)-bright (n=66). The adenoma detection rate (ADR) and adenoma characteristics were evaluated on the basis of imaging technique.

Study participants were aged ³50 years (85.9%) and 57.1% were women. Significant group differences were not observed for clinical characteristics.

A total of 296 lesions were detected, corresponding with an overall lesion detection rate of 75.6%; individual detection rates were 84.1% for LCI, 70% for WLI, and 72.7% for BLI-bright. A total of 251 adenomas were detected, corresponding with an overall ADR of 62%, with 71.0% for LCI, 52.9% for WLI, and 62.1% for BLI-bright. LCI had a significantly higher ADR than WLI (P =.04) and no differences were observed between LCI and BLI-bright (P =.28) or BLI-bright and WLI (P =.30).

The average number of adenomas per patient was 1.17; patients with adenomas were aged mean 58.8±9 years, 51.7% were women, and the lesions were 4.4±3.1 mm in diameter. Most lesions (84.7%) were £5 mm in size. No group differences were observed on the basis of lesion size.

Adenomas were more likely to be found in the right colon segment than the left (odds ratio [OR], 2.18; 95% CI, 1.13-4.21; P =.02). Advanced adenomas were detected among 20.5% of patients.

This study may have been limited by its single center design and by the fact that the endoscopists had high levels of experience using LCI; therefore, these results may not be as generalizable.

The study authors concluded that surveillance endoscopy with LCI was more effective than WLI for detecting adenomas.


dos Santos CEO, Malaman D, Sanmartin IDA, Onófrio FdQ, Pereira-Lima JC. Effect of linked-color imaging on the detection of adenomas in screening colonoscopies. J Clin Gastroenterol. Published online August 18, 2021. doi:10.1097/MCG.0000000000001601