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High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study.
Endoscopy. 2005 Oct; 37(10):929-36.E

Abstract

BACKGROUND AND STUDY AIMS

High-resolution endoscopy (HRE) may improve the detection of early neoplasia in Barrett's esophagus. Indigo carmine chromoendoscopy (ICC) and narrow-band imaging (NBI) may be useful techniques to complement HRE. The aim of this study was to compare HRE-ICC with HRE-NBI for the detection of high-grade dysplasia or early cancer (HGD/EC) in patients with Barrett's esophagus.

PATIENTS AND METHODS

Twenty-eight patients with Barrett's esophagus underwent HRE-ICC and HRE-NBI (separated by 6 - 8 weeks) in a randomized sequence. The two procedures were performed by two different endoscopists, who were blinded to the findings of the other examination. Targeted biopsies were taken from all detected lesions, followed by four-quadrant biopsies at 2-cm intervals. Biopsy evaluation was supervised by a single expert pathologist, who was blinded to the imaging technique used.

RESULTS

Fourteen patients were diagnosed with HGD/EC. The sensitivity for HGD/EC was 93 % and 86 % for HRE-ICC and HRE-NBI, respectively. Targeted biopsies had a sensitivity of 79 % with HRE alone. HGD was diagnosed from random biopsies alone in only one patient. ICC and NBI detected a limited number of additional lesions occult to HRE, but these lesions did not alter the sensitivity for identifying patients with HGD/EC.

CONCLUSIONS

In most patients with high-grade dysplasia or early cancer in Barrett's esophagus, subtle lesions can be identified with high-resolution endoscopy. Indigo carmine chromoendoscopy and narrow-band imaging are comparable as adjuncts to high-resolution endoscopy.

Authors+Show Affiliations

Dept. of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16189764

Citation

Kara, M A., et al. "High-resolution Endoscopy Plus Chromoendoscopy or Narrow-band Imaging in Barrett's Esophagus: a Prospective Randomized Crossover Study." Endoscopy, vol. 37, no. 10, 2005, pp. 929-36.
Kara MA, Peters FP, Rosmolen WD, et al. High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study. Endoscopy. 2005;37(10):929-36.
Kara, M. A., Peters, F. P., Rosmolen, W. D., Krishnadath, K. K., ten Kate, F. J., Fockens, P., & Bergman, J. J. (2005). High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study. Endoscopy, 37(10), 929-36.
Kara MA, et al. High-resolution Endoscopy Plus Chromoendoscopy or Narrow-band Imaging in Barrett's Esophagus: a Prospective Randomized Crossover Study. Endoscopy. 2005;37(10):929-36. PubMed PMID: 16189764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study. AU - Kara,M A, AU - Peters,F P, AU - Rosmolen,W D, AU - Krishnadath,K K, AU - ten Kate,F J, AU - Fockens,P, AU - Bergman,J J G H, PY - 2005/9/29/pubmed PY - 2006/1/6/medline PY - 2005/9/29/entrez SP - 929 EP - 36 JF - Endoscopy JO - Endoscopy VL - 37 IS - 10 N2 - BACKGROUND AND STUDY AIMS: High-resolution endoscopy (HRE) may improve the detection of early neoplasia in Barrett's esophagus. Indigo carmine chromoendoscopy (ICC) and narrow-band imaging (NBI) may be useful techniques to complement HRE. The aim of this study was to compare HRE-ICC with HRE-NBI for the detection of high-grade dysplasia or early cancer (HGD/EC) in patients with Barrett's esophagus. PATIENTS AND METHODS: Twenty-eight patients with Barrett's esophagus underwent HRE-ICC and HRE-NBI (separated by 6 - 8 weeks) in a randomized sequence. The two procedures were performed by two different endoscopists, who were blinded to the findings of the other examination. Targeted biopsies were taken from all detected lesions, followed by four-quadrant biopsies at 2-cm intervals. Biopsy evaluation was supervised by a single expert pathologist, who was blinded to the imaging technique used. RESULTS: Fourteen patients were diagnosed with HGD/EC. The sensitivity for HGD/EC was 93 % and 86 % for HRE-ICC and HRE-NBI, respectively. Targeted biopsies had a sensitivity of 79 % with HRE alone. HGD was diagnosed from random biopsies alone in only one patient. ICC and NBI detected a limited number of additional lesions occult to HRE, but these lesions did not alter the sensitivity for identifying patients with HGD/EC. CONCLUSIONS: In most patients with high-grade dysplasia or early cancer in Barrett's esophagus, subtle lesions can be identified with high-resolution endoscopy. Indigo carmine chromoendoscopy and narrow-band imaging are comparable as adjuncts to high-resolution endoscopy. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/16189764/High_resolution_endoscopy_plus_chromoendoscopy_or_narrow_band_imaging_in_Barrett's_esophagus:_a_prospective_randomized_crossover_study_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2005-870433 DB - PRIME DP - Unbound Medicine ER -