X Sun, Y Liu, M Min, Y Bi, Y Xu -Journal of Cancer Research and Therapeutics, 2017 

Sir,

Linked color imaging (LCI) is a newly developed endoscopic technique,[1,2] which might enhance the effectiveness of endoscopic diagnosis and intervention for gastrointestinal diseases. So far, only a few studies on LCI have been reported, and the clinical application of LCI has attracted great attentions from all over the world.

We first investigated the application of LCI in improving the diagnostic efficacy of gastrointestinal mucosal disease. Our study showed that LCI technique could make the red mucosal area redder and white mucosal area whiter.[1,3,4] Our previous data have validated that LCI technique could have diagnostic field and improve the endoscopic diagnostic accuracy for gastrointestinal mucosal lesions[5] and the calculation of pixel brightness for specific target area could be introduced as an objective marker for analyzing the endoscopic images. LCI could be able to enhance the color contrast and thus facilitate the identification of mucosal lesions, especially bleeding points during endoscopic interventions.

Endoscopic submucosal dissection (ESD) as a typical endoscopic intervention has been widely applied in recent years, which aims at the en bloc resection of mucosal lesions in gastrointestinal tract, while the relatively high risk of post‑ESD complications greatly limits the clinical application of ESD. Among the post-ESD complications, bleeding is one of the most common. To prevent the occurrence of bleeding, a variety of new endoscopic imaging. LCI may have the potential of benefiting such patients who have high risk of bleeding after ESD due to its special imaging principles. We reported a patient with rectal neuroendocrine tumor who was successfully treated by LCI‑assisted ESD. LCI‑assisted ESD procedure was feasible and safe. LCI mode was recommended for observing the mucosa when bleeding was suspected because LCI could only observe the superficial submucosa. Seen from this, the application of LCI may be promising mode in optimizing the current endoscopic strategy, which remains to be further examined in future researches.