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Gastrointest Endosc. 2009 Nov;70(5):899-906. doi: 10.1016/j.gie.2009.03.1171.

Trimodal imaging endoscopy may improve diagnostic accuracy of early gastric neoplasia: a feasibility study.

Author information

1
Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan. masa-kato@jikei.ac.jp

Abstract

BACKGROUND:

A considerable number of superficial gastric neoplasias are overlooked with conventional white light imaging (WLI) endoscopy.

OBJECTIVE:

The aim was to investigate the diagnostic potential of trimodal imaging endoscopy (TME), which combines WLI, autofluorescence imaging (AFI), and narrow-band imaging (NBI), for superficial gastric neoplasia.

DESIGN:

Feasibility study.

SETTING:

Single academic center.

PATIENTS:

Sixty-two patients with or without gastric neoplasia.

INTERVENTION:

Each patient serially assessed with WLI, AFI, and magnifying endoscopy with NBI (ME-NBI) by an endoscopist blinded for clinical information. ME-NBI over WLI and AFI was designated as TME. Histopathology of biopsy and ESD specimens was evaluated and used as the gold standard.

MAIN OUTCOME MEASUREMENTS:

Sensitivity and specificity of endoscopic diagnosis of pathology-proven neoplasia by per-patient and per-lesion analyses.

RESULTS:

The study included 47 pathology-proven neoplasias and 44 pathology-proven nonneoplasias that were detected as neoplasias with any of the modalities. By a per-lesion analysis, the sensitivity of TME (89.4%) was higher than that of WLI (76.6%) and AFI (68.1%). The specificity of TME (98.0%) was higher than that of WLI (84.3%) and AFI (23.5%). By a per-patient analysis, the sensitivity of TME (90.9%) was higher than that of WLI (75%) and AFI (68.2%). The specificity of TME (100%) was higher than that of WLI (72.2%) and AFI (44.4%).

LIMITATIONS:

Case-enriched population at a single center.

CONCLUSIONS:

Higher diagnostic accuracy of TME over conventional WLI indicates the feasibility of TME for the efficacious diagnosis of early gastric neoplasia.

Comment in

PMID:
19595318
DOI:
10.1016/j.gie.2009.03.1171
[Indexed for MEDLINE]

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