Tags

Type your tag names separated by a space and hit enter

Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus.
Gastroenterology. 2008 Jul; 135(1):24-31.G

Abstract

BACKGROUND & AIMS

High-resolution endoscopy with narrow band imaging (NBI) enhances the visualization of mucosal glandular and vascular structures. This study assessed whether narrow band targeted biopsies could detect advanced dysplasia using fewer biopsy samples compared with standard resolution endoscopy.

METHODS

We conducted a prospective, blinded, tandem endoscopy study in a tertiary care center with 65 patients with Barrett's esophagus undergoing evaluation for previously detected dysplasia. Standard resolution endoscopy was used first to detect visible lesions. Narrow band endoscopy was then used by another gastroenterologist to detect and biopsy areas suspicious for dysplasia. The lesions initially detected by standard resolution endoscopy were then disclosed and biopsied, after biopsy of the lesions targeted with NBI. Finally, random 4-quadrant biopsies were taken throughout the segment of Barrett's mucosa.

RESULTS

Higher grades of dysplasia were found by NBI in 12 patients (18%), compared with no cases (0%) in whom standard resolution white light endoscopy with random biopsy detected a higher grade of histology (P < .001). Correspondingly, narrow band directed biopsies detected dysplasia in more patients (n = 37; 57%) compared with biopsies taken using standard resolution endoscopy (n = 28; 43%). In addition, more biopsies were taken using standard resolution endoscopy with random biopsy compared with narrow band targeted biopsies (mean 8.5 versus 4.7; P < .001).

CONCLUSIONS

In patients evaluated for Barrett's esophagus with dysplasia, NBI detected significantly more patients with dysplasia and higher grades of dysplasia with fewer biopsy samples compared with standard resolution endoscopy.

Authors+Show Affiliations

Division of Gastroenterology, Laboratory Medicine and Biostatistics Unit, Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida 32224, 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18442484

Citation

Wolfsen, Herbert C., et al. "Prospective, Controlled Tandem Endoscopy Study of Narrow Band Imaging for Dysplasia Detection in Barrett's Esophagus." Gastroenterology, vol. 135, no. 1, 2008, pp. 24-31.
Wolfsen HC, Crook JE, Krishna M, et al. Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. Gastroenterology. 2008;135(1):24-31.
Wolfsen, H. C., Crook, J. E., Krishna, M., Achem, S. R., Devault, K. R., Bouras, E. P., Loeb, D. S., Stark, M. E., Woodward, T. A., Hemminger, L. L., Cayer, F. K., & Wallace, M. B. (2008). Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. Gastroenterology, 135(1), 24-31. https://doi.org/10.1053/j.gastro.2008.03.019
Wolfsen HC, et al. Prospective, Controlled Tandem Endoscopy Study of Narrow Band Imaging for Dysplasia Detection in Barrett's Esophagus. Gastroenterology. 2008;135(1):24-31. PubMed PMID: 18442484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett's Esophagus. AU - Wolfsen,Herbert C, AU - Crook,Julia E, AU - Krishna,Murli, AU - Achem,Sami R, AU - Devault,Kenneth R, AU - Bouras,Ernest P, AU - Loeb,David S, AU - Stark,Mark E, AU - Woodward,Timothy A, AU - Hemminger,Lois L, AU - Cayer,Frances K, AU - Wallace,Michael B, Y1 - 2008/03/21/ PY - 2007/09/10/received PY - 2008/02/25/revised PY - 2008/03/13/accepted PY - 2008/4/30/pubmed PY - 2008/8/9/medline PY - 2008/4/30/entrez SP - 24 EP - 31 JF - Gastroenterology JO - Gastroenterology VL - 135 IS - 1 N2 - BACKGROUND & AIMS: High-resolution endoscopy with narrow band imaging (NBI) enhances the visualization of mucosal glandular and vascular structures. This study assessed whether narrow band targeted biopsies could detect advanced dysplasia using fewer biopsy samples compared with standard resolution endoscopy. METHODS: We conducted a prospective, blinded, tandem endoscopy study in a tertiary care center with 65 patients with Barrett's esophagus undergoing evaluation for previously detected dysplasia. Standard resolution endoscopy was used first to detect visible lesions. Narrow band endoscopy was then used by another gastroenterologist to detect and biopsy areas suspicious for dysplasia. The lesions initially detected by standard resolution endoscopy were then disclosed and biopsied, after biopsy of the lesions targeted with NBI. Finally, random 4-quadrant biopsies were taken throughout the segment of Barrett's mucosa. RESULTS: Higher grades of dysplasia were found by NBI in 12 patients (18%), compared with no cases (0%) in whom standard resolution white light endoscopy with random biopsy detected a higher grade of histology (P < .001). Correspondingly, narrow band directed biopsies detected dysplasia in more patients (n = 37; 57%) compared with biopsies taken using standard resolution endoscopy (n = 28; 43%). In addition, more biopsies were taken using standard resolution endoscopy with random biopsy compared with narrow band targeted biopsies (mean 8.5 versus 4.7; P < .001). CONCLUSIONS: In patients evaluated for Barrett's esophagus with dysplasia, NBI detected significantly more patients with dysplasia and higher grades of dysplasia with fewer biopsy samples compared with standard resolution endoscopy. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/18442484/Prospective_controlled_tandem_endoscopy_study_of_narrow_band_imaging_for_dysplasia_detection_in_Barrett's_Esophagus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)00455-1 DB - PRIME DP - Unbound Medicine ER -