TY - JOUR
T1 - Blue-light imaging and linked-color imaging improve visualization of Barrett's neoplasia by nonexpert endoscopists
AU - de Groof, Albert J.
AU - Fockens, Kiki N.
AU - Struyvenberg, Maarten R.
AU - Pouw, Roos E.
AU - Weusten, Bas L.A.M.
AU - Schoon, Erik J.
AU - Mostafavi, Nahid
AU - Bisschops, Raf
AU - Curvers, Wouter L.
AU - Bergman, Jacques J.
N1 - Funding Information:
This study was supported by an unrestricted research grant from FUJIFILM Europe (FUJIFILM Europe GmbH, Düsseldorf, Germany), which had no involvement in the design, recruitment, data collection, analysis, interpretation, or writing of the manuscript.
Funding Information:
This study was supported by an unrestricted research grant from FUJIFILM Europe (FUJIFILM Europe GmbH, D?sseldorf, Germany), which had no involvement in the design, recruitment, data collection, analysis, interpretation, or writing of the manuscript. DISCLOSURE: Dr Bergman has received research support and speaker fees from FUJIFILM. Dr Bisschops has received research support, consulting fees, and speaker fees from FUJIFILM. All other authors disclosed no financial relationships.
Publisher Copyright:
© 2020 American Society for Gastrointestinal Endoscopy
PY - 2020/5
Y1 - 2020/5
N2 - Background and Aims: Endoscopic recognition of early Barrett's neoplasia is challenging. Blue-light imaging (BLI) and linked-color imaging (LCI) may assist endoscopists in appreciation of neoplasia. Our aim was to evaluate BLI and LCI for visualization of Barrett's neoplasia in comparison with white-light endoscopy (WLE) alone, when assessed by nonexpert endoscopists. Methods: In this web-based assessment, corresponding WLE, BLI, and LCI images of 30 neoplastic Barrett's lesions were delineated by 3 expert endoscopists to establish ground truth. These images were then scored and delineated by 76 nonexpert endoscopists from 3 countries and with different levels of expertise, in 4 separate assessment phases with a washout period of 2 weeks. Assessments were as follows: assessment 1, WLE only; assessment 2, WLE + BLI; assessment 3, WLE + LCI; assessment 4, WLE + BLI + LCI. The outcomes were (1) appreciation of macroscopic appearance and ability to delineate lesions (visual analog scale [VAS] scores); (2) preferred technique (ordinal scores); and (3) assessors’ delineation performance in terms of overlap with expert ground truth. Results: Median VAS scores for phases 2 to 4 were significantly higher than in phase 1 (P < .001). Assessors preferred BLI and LCI over WLE for appreciation of macroscopic appearance (P < .001) and delineation (P < .001). Linear mixed-effect models showed that delineation performance increased significantly in phase 4. Conclusions: The use of BLI and LCI has significant additional value for the visualization of Barrett's neoplasia when used by nonexpert endoscopists. Assessors appreciated the addition of BLI and LCI better than the use of WLE alone. Furthermore, this addition led to improved delineation performance, thereby allowing for better acquisition of targeted biopsy samples. (The Netherlands Trial Registry number: NL7541.)
AB - Background and Aims: Endoscopic recognition of early Barrett's neoplasia is challenging. Blue-light imaging (BLI) and linked-color imaging (LCI) may assist endoscopists in appreciation of neoplasia. Our aim was to evaluate BLI and LCI for visualization of Barrett's neoplasia in comparison with white-light endoscopy (WLE) alone, when assessed by nonexpert endoscopists. Methods: In this web-based assessment, corresponding WLE, BLI, and LCI images of 30 neoplastic Barrett's lesions were delineated by 3 expert endoscopists to establish ground truth. These images were then scored and delineated by 76 nonexpert endoscopists from 3 countries and with different levels of expertise, in 4 separate assessment phases with a washout period of 2 weeks. Assessments were as follows: assessment 1, WLE only; assessment 2, WLE + BLI; assessment 3, WLE + LCI; assessment 4, WLE + BLI + LCI. The outcomes were (1) appreciation of macroscopic appearance and ability to delineate lesions (visual analog scale [VAS] scores); (2) preferred technique (ordinal scores); and (3) assessors’ delineation performance in terms of overlap with expert ground truth. Results: Median VAS scores for phases 2 to 4 were significantly higher than in phase 1 (P < .001). Assessors preferred BLI and LCI over WLE for appreciation of macroscopic appearance (P < .001) and delineation (P < .001). Linear mixed-effect models showed that delineation performance increased significantly in phase 4. Conclusions: The use of BLI and LCI has significant additional value for the visualization of Barrett's neoplasia when used by nonexpert endoscopists. Assessors appreciated the addition of BLI and LCI better than the use of WLE alone. Furthermore, this addition led to improved delineation performance, thereby allowing for better acquisition of targeted biopsy samples. (The Netherlands Trial Registry number: NL7541.)
UR - http://www.scopus.com/inward/record.url?scp=85083309088&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2019.12.037
DO - 10.1016/j.gie.2019.12.037
M3 - Article
C2 - 31904377
AN - SCOPUS:85083309088
SN - 0016-5107
VL - 91
SP - 1050
EP - 1057
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 5
ER -