Linked Color Imaging (LCI) Emphasizes the Color Changes in the Gastric Mucosa After Helicobacter pylori Eradication

Hiroyuki Sakae, Hiromitsu Kanzaki, Takuya Satomi, Shotaro Okanoue, Yuka Obayashi, Kenta Hamada, Makoto Abe, Yoshiyasu Kono, Ko Miura, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai, Hiroyuki Okada

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: Diffuse redness is a characteristic endoscopic finding that indicates current infection of Helicobacter pylori, which is reduced after successful eradication. Linked color imaging (LCI) has been reported to improve the visibility of diffuse redness compared to white light imaging (WLI); however, quantitative evaluation has not been reported. Aims: This study aimed to objectively evaluate the color change of the gastric mucosa after H. pylori eradication. Methods: Images of the greater curvature of the antrum and corpus were captured, and the sites were biopsied during esophagogastroduodenoscopy (EGD) before and 1 year after eradication. The region of interest (ROI) was set around the biopsied area on the images. The color difference (ΔE) before and after eradication was calculated using the CIE L*a*b* color space. The association between the histological evaluation and the color value of the corresponding ROI was determined. Results: At the antrum, there was no significant color change with either mode. At the corpus, the a* value, which reflected redness, decreased significantly after eradication with both modes (WLI: 41.2 to 36.0, LCI: 37.5 to 25.5); the b* value, reflecting yellowish, decreased with WLI, but increased significantly with LCI (WLI: 44.6 to 41.6, LCI: 23.9 to 29.2). The ΔE was significantly larger with LCI than with WLI (16.5 vs. 8.6). The a* values at the corpus were generally associated with histological neutrophil infiltration. Conclusions: Quantitative evaluation revealed that LCI emphasizes the change in color of the gastric mucosa due to the reduction in diffuse redness.

Original languageEnglish
JournalDigestive Diseases and Sciences
Publication statusAccepted/In press - 2021


  • Diffuse redness
  • Gastritis
  • Helicobacter pylori
  • Linked color imaging

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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