By increasing the visibility of aberrant findings, linked color imaging (LCI) can help to improve the diagnostic accuracy of eosinophilic esophagitis, with "moderate" to "considerable" consistency, resulting in decreased diagnostic discrepancies across endoscopists, according to a study published in "DEN Open". Yasuhiko Abe et al. aimed to evaluate the advantages of LCI in endoscopic detection of eosinophilic esophagitis.

Ten endoscopists, comprising 4 experts (Exs) and 6 non-Exs, assessed 30 white light pictures (WLIs) and 30 WLI+LCI images obtained from subjects with and without eosinophilic esophagitis at random and in a blind fashion. The diagnosis of eosinophilic esophagitis was evaluated based on ratings of strictures, exudate furrows, ring, and edema on the adjusted eosinophilic esophagitis endoscopic reference score. In this preliminary retrospective study, inter- and intra-observer agreements among endoscopists were assessed utilizing the kappa value.

Particularly among non-Exs or endoscopists without prior experience with patients suffering from eosinophilic esophagitis, WLI+LCI images demonstrated a greater diagnostic accuracy for eosinophilic esophagitis than WLIs (0.85 vs. 0.70). For eosinophilic esophagitis diagnosis (kappa, 0.67 vs. 0.57), stricture (kappa, 0.51 vs. 0.39), and furrows (kappa, 0.73 vs. 0.67), inter-observer agreement for WLI+LCI images significantly outperformed WLIs.

The disparities between non-Exs and Ex endoscopists were lessened as a result of the improvement in inter-observer agreement in WLI+LCI images. WLI+LCI images had better intra-observer agreement than WLIs for rings (kappa, 0.62 vs. 0.43), and regardless of whether there were Exs or not, a comparable trend was observed in diagnoses, furrows, and exudates. Hence, LCI is valuable in the endoscopic detection of eosinophilic esophagitis.