Abstract
Background and aims Recent studies recommend histological mucosal healing of intestinal tissue as a treatment
goal in ulcerative colitis (UC). Linked-color imaging (LCI) is a new endoscopy system
that enhances the color differences of the gastrointestinal mucosa. We investigated
the efficacy of LCI in the evaluation of intestinal activity, including the histological
activity in UC.
Method A total of 21 UC patients who were evaluated by the LASEREO system (FUJIFILM Co.,
Tokyo, Japan) were enrolled from August to December in 2016. All of the target points
were observed by conventional white-light imaging (WLI) and LCI and biopsied from
the region of interest in each view. We quantified the color tones of 73 biopsied
points on WLI and LCI using the L*a*b* color value (WLI-L, WLI-a, WLI-b, and LCI-L,
LCI-a, LCI-b). We then investigated the relationships among the L*a*b* color values,
endoscopic findings, and histological healing.
Results The average LCI-a and LCI-b values of patients with high mucosal activity disease
were significantly higher than in those with mucosal healing (P < 0.01), and only LCI-a was significantly correlated with the score for histological
healing. With regard to the other color values (LCI-L and all WLI values), there were
no statistically significant differences in terms of average color value and correlation
between patients with high mucosal activity and those with mucosal healing. In addition,
the difference in the average color values with LCI and WLI was 7.1 and 3.1, respectively.
Conclusion LCI is more useful than WLI for the visualization and evaluation of mucosal inflammation
in UC.