BACKGROUND: A narrow band imaging (NBI) endoscopy system has been developed that allows superficial surface imaging of esophageal tissue in vivo. OBJECTIVE: The objective was to assess the potential of NBI for prediction of histology during screening and surveillance endoscopy in patients with Barrett's esophagus (BE). DESIGN: A prospective cohort study. SETTING: Veterans Affairs Medical Center. PATIENTS: Fifty-one patients with known or suspected BE. METHODS: NBI images were graded according to mucosal pattern (ridge/villous, circular and irregular/distorted) and vascular pattern (normal and abnormal), and correlated with histology in a prospective, blinded manner. MAIN OUTCOME MEASUREMENTS: Biopsy-confirmed intestinal metaplasia (IM) and dysplasia were used as the outcome measures. RESULTS: Of 51 patients (mean BE length 3.5 cm), 28 had IM without dysplasia, 8 had low-grade dysplasia (LGD), 7 had high-grade dysplasia (HGD), and 8 had cardiac-type mucosa. The sensitivity, specificity, and positive predictive value of ridge/villous pattern for diagnosis of IM without HGD were 93.5%, 86.7%, and 94.7%, respectively. The sensitivity, specificity, and positive predictive value of irregular/distorted pattern for HGD were 100%, 98.7%, and 95.3%, respectively. If biopsies were limited to areas with irregular/distorted pattern, no patient with HGD would have been missed. However, NBI was unable to distinguish areas of IM from those with LGD. LIMITATIONS: The open study design without a control group was the main limitation. CONCLUSIONS: NBI is a novel diagnostic tool with a high degree of accuracy for the detection of metaplastic and dysplastic tissue within the BE segment.
BACKGROUND: A narrow band imaging (NBI) endoscopy system has been developed that allows superficial surface imaging of esophageal tissue in vivo. OBJECTIVE: The objective was to assess the potential of NBI for prediction of histology during screening and surveillance endoscopy in patients with Barrett's esophagus (BE). DESIGN: A prospective cohort study. SETTING: Veterans Affairs Medical Center. PATIENTS: Fifty-one patients with known or suspected BE. METHODS: NBI images were graded according to mucosal pattern (ridge/villous, circular and irregular/distorted) and vascular pattern (normal and abnormal), and correlated with histology in a prospective, blinded manner. MAIN OUTCOME MEASUREMENTS: Biopsy-confirmed intestinal metaplasia (IM) and dysplasia were used as the outcome measures. RESULTS: Of 51 patients (mean BE length 3.5 cm), 28 had IM without dysplasia, 8 had low-grade dysplasia (LGD), 7 had high-grade dysplasia (HGD), and 8 had cardiac-type mucosa. The sensitivity, specificity, and positive predictive value of ridge/villous pattern for diagnosis of IM without HGD were 93.5%, 86.7%, and 94.7%, respectively. The sensitivity, specificity, and positive predictive value of irregular/distorted pattern for HGD were 100%, 98.7%, and 95.3%, respectively. If biopsies were limited to areas with irregular/distorted pattern, no patient with HGD would have been missed. However, NBI was unable to distinguish areas of IM from those with LGD. LIMITATIONS: The open study design without a control group was the main limitation. CONCLUSIONS: NBI is a novel diagnostic tool with a high degree of accuracy for the detection of metaplastic and dysplastic tissue within the BE segment.
Authors: K K Wang; J M Tian; E Gorospe; J Penfield; G Prasad; T Goddard; M Wongkeesong; N S Buttar; L Lutzke; S Krishnadath Journal: Dis Esophagus Date: 2012-03-12 Impact factor: 3.429
Authors: Kenshi Yao; George K Anagnostopoulos; Aida U Jawhari; Philip V Kaye; Chris J Hawkey; Krish Ragunath Journal: Gut Liver Date: 2008-06-30 Impact factor: 4.519
Authors: Jordan A Sweer; Mason T Chen; Kevan J Salimian; Richard J Battafarano; Nicholas J Durr Journal: J Biophotonics Date: 2019-06-14 Impact factor: 3.207