BACKGROUND AND AIMS Endoscopic recognition of early Barrett's neoplasia is challenging. Blue-light imaging (BLI) and linked-color imaging (LCI) may assist endoscopists in appreciation of neoplasia. Our aim was to evaluate BLI and LCI for visualization of Barrett's neoplasia in comparison with white-light endoscopy (WLE) alone, when assessed by nonexpert endoscopists. METHODS In this web-based assessment, corresponding WLE, BLI, and LCI images of 30 neoplastic Barrett's lesions were delineated by 3 expert endoscopists to establish ground truth. These images were then scored and delineated by 76 nonexpert endoscopists from 3 countries and with different levels of expertise, in 4 separate assessment phases with a washout period of 2 weeks. Assessments were as follows: assessment 1, WLE only; assessment 2, WLE + BLI; assessment 3, WLE + LCI; assessment 4, WLE + BLI + LCI. The outcomes were (1) appreciation of macroscopic appearance and ability to delineate lesions (visual analog scale [VAS] scores); (2) preferred technique (ordinal scores); and (3) assessors' delineation performance in terms of overlap with expert ground truth. RESULTS Median VAS scores for phases 2 to 4 were significantly higher than in phase 1 (P < .001). Assessors preferred BLI and LCI over WLE for appreciation of macroscopic appearance (P < .001) and delineation (P < .001). Linear mixed-effect models showed that delineation performance increased significantly in phase 4. CONCLUSIONS The use of BLI and LCI has significant additional value for the visualization of Barrett's neoplasia when used by nonexpert endoscopists. Assessors appreciated the addition of BLI and LCI better than the use of WLE alone. Furthermore, this addition led to improved delineation performance, thereby allowing for better acquisition of targeted biopsy samples. (The Netherlands Trial Registry number: NL7541.).

中文翻译：

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蓝光成像和链接彩色成像可提高非专业内镜医师对Barrett瘤形成的可视化。

背景与目的内镜下早期Barrett瘤形成的识别具有挑战性。蓝光成像（BLI）和链接彩色成像（LCI）可以帮助内镜医师欣赏瘤形成。我们的目的是评估BLI和LCI，与由非专业内镜医师进行评估时相比，仅与白光内窥镜检查（WLE）相比，观察巴雷特的瘤形成情况。方法在此基于Web的评估中，由3位专业内镜医师对30例肿瘤Barrett病灶的相应WLE，BLI和LCI图像进行了描述，以建立基本事实。然后，这些图像由来自3个国家和不同专业水平的76名非专业内镜医师在4个单独的评估阶段进行评分和描绘，评估阶段为2周。评估如下：评估1，仅WLE；评估2，WLE + BLI；评估3，WLE + LCI；评估4，WLE + BLI + LCI。结果是（1）对肉眼可见的外观和描述病变的能力（视觉模拟评分[VAS]评分）；（2）首选技术（普通分数）；（3）评估者在与专家基本事实重叠方面的表现。结果第2到第4阶段的中值VAS分数显着高于第1阶段（P <.001）。与欣赏WLE相比，评估师更喜欢BLI和LCI，以欣赏宏观外观（P <.001）和轮廓（P <.001）。线性混合效应模型表明，在第4阶段的描绘性能显着提高。结论当非专业内镜医师使用BLI和LCI进行Barrett瘤形成可视化时，它具有显着的附加价值。评估人员赞赏添加BLI和LCI比单独使用WLE更好。此外，这种添加导致了改进的描绘性能，从而允许更好地采集目标活检样品。（荷兰审判注册号：NL7541。）。