A multinational study for the comparison of LED and LASER endoscope about BLI magnified images of colorectal tumors.

[Background]A high-definition LED endoscope (ELUXEO, Fujifilm) in the West enables to achieve clear blue light imaging (BLI) similar to LASER endoscope in Japan. In this multinational study, we compared BLI images of LED to those of LASER for diagnosing colorectal tumors. [Method]We reviewed 32 colorectal tumors at our hospital, which were observed both with LED and LASER endoscope. BLI magnified images were evaluated by endoscopists in 3 areas such as Asia (Taiwan, Malaysia, and Singapore), the West (Brazil, USA, Germany, and Australia), and Japan, using JNET classification. [Results]Mean tumor size was 19.9 ± 15.2 mm and the histopathological diagnosis was 10 serrated lesions, 12 adenomas, and 10 T1s. The mean diagnostic accuracy of LED and LASER was 83.3% vs. 83.3% in Japan, 70.3% vs. 65.6% in Asia, 70.3% vs. 71.9% in the West. The detail comparison of BLI images (LED better/similar/LASER better) about surface pattern was 24.0%/ 37.5%/ 38.5% in Japan, in 40.6%/ 15.6%/ 43.8% in Asia, and 17.2%/ 50.0%/ 32.8% in the West. [Conclusion] We could compare the BLI images of LED to those of LASER. The diagnostic accuracy in Japan was better than other areas and the subjective comparison of images showed diversity. Now, we are performing further analyses of BLI and Linked color imaging in each area and experience level.