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Gastrointest Endosc. 2006 Aug;64(2):167-75.

The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus.

Author information

  • 1Division of Gastroenterology and Hepatology, Department of Pathology, and Kansas Cancer Institute, University of Kansas School of Medicine and Veterans Affairs Medical Center, Kansas City, Missouri 64128-2295, USA.

Abstract

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.

PMID:
16860063
[PubMed - indexed for MEDLINE]
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