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Comparison of high-resolution magnification narrow-band imaging and white-light endoscopy in the prediction of histology in Barrett's oesophagus.
Scand J Gastroenterol 2009; 44(1):85-92SJ

Abstract

OBJECTIVE

To evaluate whether there is any appreciable difference in imaging characteristics between high-resolution magnification white-light endoscopy (WLE-Z) and narrow-band imaging (NBI-Z) in Barrett's oesophagus (BE) and if this translates into superior prediction of histology.

MATERIAL AND METHODS

This was a prospective single-centre study involving 21 patients (75 areas, corresponding NBI-Z and WLE-Z images) with BE. Mucosal patterns (pit pattern and microvascular morphology) were evaluated for their image quality on a visual analogue scale (VAS) of 1-10 by five expert endoscopists. The endoscopists then predicted mucosal morphology based on four subtypes which can be visualized in BE. Type A: round pits, regular microvasculature; type B: villous/ridge pits, regular microvasculature; type C: absent pits, regular microvasculature; type D: distorted pits, irregular microvasculature. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (Acc) were then compared with the final histopathological analysis and the interobserver variability calculated.

RESULTS

The overall pit and microvasculature quality was significantly higher for NBI-Z, pit: NBI-Z=6, WLE-Z=4.5, p < 0.001; microvasculature: NBI-Z=7.3, WLE-Z=4.9, p < 0.001. This translated into a superior prediction of histology (Sn: NBI-Z: 88.9, WLE-Z: 71.9, p < 0.001). For the prediction of dysplasia, NBI-Z was superior to WLE-Z (chi(2)=10.3, p < 0.05). The overall kappa agreement among the five endoscopists for NBI-Z and WLE-Z, respectively, was 0.59 and 0.31 (p < 0.001).

CONCLUSIONS

NBI-Z is superior to WLE-Z in the prediction of histology in BE, with good reproducibility. This novel imaging modality could be an important tool for surveillance of patients with BE.

Authors+Show Affiliations

Wolfson Digestive Diseases Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK. rajvinder.singh@health.sa.gov.auNo 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)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18821132

Citation

Singh, Rajvinder, et al. "Comparison of High-resolution Magnification Narrow-band Imaging and White-light Endoscopy in the Prediction of Histology in Barrett's Oesophagus." Scandinavian Journal of Gastroenterology, vol. 44, no. 1, 2009, pp. 85-92.
Singh R, Karageorgiou H, Owen V, et al. Comparison of high-resolution magnification narrow-band imaging and white-light endoscopy in the prediction of histology in Barrett's oesophagus. Scand J Gastroenterol. 2009;44(1):85-92.
Singh, R., Karageorgiou, H., Owen, V., Garsed, K., Fortun, P. J., Fogden, E., ... Ragunath, K. (2009). Comparison of high-resolution magnification narrow-band imaging and white-light endoscopy in the prediction of histology in Barrett's oesophagus. Scandinavian Journal of Gastroenterology, 44(1), pp. 85-92. doi:10.1080/00365520802400818.
Singh R, et al. Comparison of High-resolution Magnification Narrow-band Imaging and White-light Endoscopy in the Prediction of Histology in Barrett's Oesophagus. Scand J Gastroenterol. 2009;44(1):85-92. PubMed PMID: 18821132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of high-resolution magnification narrow-band imaging and white-light endoscopy in the prediction of histology in Barrett's oesophagus. AU - Singh,Rajvinder, AU - Karageorgiou,Haris, AU - Owen,Victoria, AU - Garsed,Klara, AU - Fortun,Paul J, AU - Fogden,Edward, AU - Subramaniam,Venkataraman, AU - Shonde,Anthony, AU - Kaye,Philip, AU - Hawkey,Christopher J, AU - Ragunath,Krish, PY - 2008/9/30/pubmed PY - 2009/3/13/medline PY - 2008/9/30/entrez SP - 85 EP - 92 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 44 IS - 1 N2 - OBJECTIVE: To evaluate whether there is any appreciable difference in imaging characteristics between high-resolution magnification white-light endoscopy (WLE-Z) and narrow-band imaging (NBI-Z) in Barrett's oesophagus (BE) and if this translates into superior prediction of histology. MATERIAL AND METHODS: This was a prospective single-centre study involving 21 patients (75 areas, corresponding NBI-Z and WLE-Z images) with BE. Mucosal patterns (pit pattern and microvascular morphology) were evaluated for their image quality on a visual analogue scale (VAS) of 1-10 by five expert endoscopists. The endoscopists then predicted mucosal morphology based on four subtypes which can be visualized in BE. Type A: round pits, regular microvasculature; type B: villous/ridge pits, regular microvasculature; type C: absent pits, regular microvasculature; type D: distorted pits, irregular microvasculature. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (Acc) were then compared with the final histopathological analysis and the interobserver variability calculated. RESULTS: The overall pit and microvasculature quality was significantly higher for NBI-Z, pit: NBI-Z=6, WLE-Z=4.5, p < 0.001; microvasculature: NBI-Z=7.3, WLE-Z=4.9, p < 0.001. This translated into a superior prediction of histology (Sn: NBI-Z: 88.9, WLE-Z: 71.9, p < 0.001). For the prediction of dysplasia, NBI-Z was superior to WLE-Z (chi(2)=10.3, p < 0.05). The overall kappa agreement among the five endoscopists for NBI-Z and WLE-Z, respectively, was 0.59 and 0.31 (p < 0.001). CONCLUSIONS: NBI-Z is superior to WLE-Z in the prediction of histology in BE, with good reproducibility. This novel imaging modality could be an important tool for surveillance of patients with BE. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/18821132/Comparison_of_high_resolution_magnification_narrow_band_imaging_and_white_light_endoscopy_in_the_prediction_of_histology_in_Barrett's_oesophagus_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520802400818 DB - PRIME DP - Unbound Medicine ER -