O impacto do "Linked Color Imaging (LCI)" na taxa de detecção de Adenomas na Colonoscopia: revisão sistemática e meta-análise

Abstract

The prevention of colorectal cancer is based on surveillance with routine colonoscopy. Among the factors of exam quality, adenoma detection rate (ADR) appears as one of the main. In this context, Linked Color Imaging (LCI) aims to intensifies the contrast of this type of lesion, improving exam performance. Randomized clinical trials in English, published up to March 2023 evaluating the use of LCI compared to white light (WL) were selected. The main objective was to assess the impact of LCI on the ADR. In addition, the evaluated outcomes encompassed the size, morphology, location and type of lesions, the number of adenomas per patient, and the supplementary detection rate, as per study methodology's allowance for such assessments. The study was registered in PROSPERO with the ID CRD42023438359. Sixteen studies were included, revealing LCI's superior accuracy in adenoma detection (1.20, 95% CI: 1.13–1.28) and increased rates per patient. Although LCI performed favorably in size, morphology, and location, subgroup analyses showed no statistically significant differences. The addition of LCI did not yield significant results for serrated lesion detection, and there were no statistically significant differences in withdrawal time between groups. LCI has proved to be efficacious in the identification of colonic lesions and increased ADR, the adenoma detection rates per patient and the additional detection rate of colonic lesions, with no negative impact on other quality criteria in colonoscopy.