A study published in the "Journal of clinical gastroenterology" depicted that by enhancing endoscopic images, linked color imaging is more sensitive to detect MCI compared with white-light imaging. Ni-Na Zhang et al. performed this study to explore the efficacy of linked color imaging and white-light imaging endoscopy in the evaluation of MCI in 41 nonerosive reflux esophagitis patients and 38 non-gastroesophageal reflux disease (GERD) subjects.

Utilizing white-light imaging followed by linked color imaging,  the distal 5 cm of the esophageal mucosal morphology at the squamocolumnar junction was visualized during upper gastrointestinal endoscopy. In both groups, assessment of the color patterns for MCI was done on the images of white-light imaging and on the images of white-light imaging combined with linked color imaging.

The percentage of MCI was more in nonerosive reflux esophagitis subjects vs. non-GERD subjects utilizing white-light imaging combined with linked color imaging, as illustrated below:

Both white-light imaging and linked color imaging demonstrated normal mucosa in 12 patients with nonerosive reflux esophagitis. In subjects having nonerosive reflux esophagitis, the MCI detection rate was greater when utilizing white-light imaging combined with linked color imaging (70.7%) than when using white-light imaging (51.2%).

The histopathologic score of MCI (+) was much greater when compared to MCI (-) patients in both the nonerosive reflux esophagitis group  and the non-GERD group, as shown below:

Compared with white-light imaging alone, the linked color imaging displayed better interobserver agreement and intraobserver reproducibility levels. Thus, in individuals with nonerosive reflux esophagitis, the frequency of MCI is greater when compared with non-GERD patients and can be detected by utilizing white-light imaging combined with linked color imaging.