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The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus.
Gastrointest Endosc. 2006 Aug; 64(2):167-75.GE

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.

Authors+Show Affiliations

Division 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.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16860063

Citation

Sharma, Prateek, et al. "The Utility of a Novel Narrow Band Imaging Endoscopy System in Patients With Barrett's Esophagus." Gastrointestinal Endoscopy, vol. 64, no. 2, 2006, pp. 167-75.
Sharma P, Bansal A, Mathur S, et al. The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus. Gastrointest Endosc. 2006;64(2):167-75.
Sharma, P., Bansal, A., Mathur, S., Wani, S., Cherian, R., McGregor, D., Higbee, A., Hall, S., & Weston, A. (2006). The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus. Gastrointestinal Endoscopy, 64(2), 167-75.
Sharma P, et al. The Utility of a Novel Narrow Band Imaging Endoscopy System in Patients With Barrett's Esophagus. Gastrointest Endosc. 2006;64(2):167-75. PubMed PMID: 16860063.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus. AU - Sharma,Prateek, AU - Bansal,Ajay, AU - Mathur,Sharad, AU - Wani,Sachin, AU - Cherian,Rachel, AU - McGregor,Douglas, AU - Higbee,April, AU - Hall,Sandra, AU - Weston,Allan, PY - 2005/07/14/received PY - 2005/10/17/accepted PY - 2006/7/25/pubmed PY - 2006/12/9/medline PY - 2006/7/25/entrez SP - 167 EP - 75 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 64 IS - 2 N2 - 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. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/16860063/The_utility_of_a_novel_narrow_band_imaging_endoscopy_system_in_patients_with_Barrett's_esophagus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(05)03167-6 DB - PRIME DP - Unbound Medicine ER -