title: Comparison of linked color imaging and white-light colonoscopy for detection of colorectal polyps: a multicenter, randomized, crossover trial.
abstract: OBJECTIVE
  Linked color imaging (LCI), a recently developed technology, uses a laser endoscopic system to enhance the color separation of red color to depict red and white colors more vividly. The benefits of LCI in the detection of colorectal polyps remain unknown. The aim of this study was to assess the ability of LCI to improve the detection of colorectal polyps compared with white-light (WL) endoscopy.
  
  
  METHODS
  We performed a multicenter, crossover, prospective, randomized controlled trial in 3 hospitals in China. All patients underwent crossover colonoscopies with LCI and WL endoscopy in a randomized order. All lesions were removed during the second endoscopic procedure. The primary outcome measure was the difference in sensitivity between LCI and WL endoscopy for the detection of colorectal polyps. The secondary outcome measures were the adenoma detection rate per patient in the 2 groups and the factors associated with polyp miss rates.
  
  
  RESULTS
  A total of 152 patients were randomized, and 141 were included in the analysis. The overall polyp detection rate increased significantly by 24% for LCI colonoscopy, corresponding to a higher sensitivity with LCI than with WL endoscopy (91% vs 73%, P < .0001). Furthermore, LCI identified significantly more patients (32%) with polyps. The per-patient adenoma detection rate was significantly higher for LCI than for WL endoscopy (37% vs 28%; 95% confidence interval, 2.39%-19.41%).
  
  
  CONCLUSIONS
  LCI improves the detection of colorectal polyps and adenomas during colonoscopy. (Clinical trial registration number: NCT02724397.).
authors.affiliation: Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Min
authors.affiliation: Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Deng
authors.affiliation: Department of Gastroenterology and Hepatology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nan Ning, Guangxi, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology and Hepatology, Shanghai Tenth People's Hospital, Shanghai, 200000, China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Gastroenterology and Hepatology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology and Hepatology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nan Ning, Guangxi, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Nong
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged