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Performance of narrow band imaging and magnification endoscopy in the prediction of therapeutic response in patients with gastroesophageal reflux disease.
J Clin Gastroenterol. 2011 Jul; 45(6):501-6.JC

Abstract

BACKGROUND

Imaging-enhanced endoscopy enhances the contrast of the mucosal surface and helps in the diagnosis of gastroesophageal reflux disease. However, whether the increased detection of subtle erosive foci corresponds to the effect of acid suppression remains elusive.

GOALS

We aim to evaluate the utility of narrow band imaging with and without magnification endoscopy in the prediction of therapeutic response in patients with reflux.

STUDY

Endoscopic evaluation with conventional white light, narrow band imaging, and narrow band imaging with magnification was performed sequentially in consecutive patients with reflux. All patients received proton pump inhibitor for 14 days. Their therapeutic responses were correlated with the baseline endoscopic findings, including mucosal breaks under standard endoscopy, mucosal brownish changes under narrow band imaging, and increased and/or dilated intrapapillary capillary loops or microerosions under narrow band imaging with magnification.

RESULTS

Of a total of 82 patients, 22 (26.8%) patients were diagnosed with erosive disease under standard endoscopy. Among the remaining 60 (73.2%) patients, 14 (23.3%) and 30 (50%) were considered erosive under narrow band imaging and narrow band imaging with magnification, respectively. Sixty-five (79.3%) patients showed a positive therapeutic response. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting therapeutic response were 33.8%, 100%, 100%, 28.3%, and 47.6%, respectively, for standard endoscopy; 52.3%, 88.2%, 94.4%, 32.6%, and 59.8%, respectively, for narrow band imaging; and 70.8%, 64.7%, 88.4%, 36.6%, and 69.5%, respectively, for narrow band imaging with magnification.

CONCLUSIONS

Narrow band imaging with and without magnification endoscopy substantially improve our ability to predict therapeutic response in patients with gastroesophageal reflux.

Authors+Show Affiliations

Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20733514

Citation

Tseng, Ping-Huei, et al. "Performance of Narrow Band Imaging and Magnification Endoscopy in the Prediction of Therapeutic Response in Patients With Gastroesophageal Reflux Disease." Journal of Clinical Gastroenterology, vol. 45, no. 6, 2011, pp. 501-6.
Tseng PH, Chen CC, Chiu HM, et al. Performance of narrow band imaging and magnification endoscopy in the prediction of therapeutic response in patients with gastroesophageal reflux disease. J Clin Gastroenterol. 2011;45(6):501-6.
Tseng, P. H., Chen, C. C., Chiu, H. M., Liao, W. C., Wu, M. S., Lin, J. T., Lee, Y. C., & Wang, H. P. (2011). Performance of narrow band imaging and magnification endoscopy in the prediction of therapeutic response in patients with gastroesophageal reflux disease. Journal of Clinical Gastroenterology, 45(6), 501-6. https://doi.org/10.1097/MCG.0b013e3181eeb115
Tseng PH, et al. Performance of Narrow Band Imaging and Magnification Endoscopy in the Prediction of Therapeutic Response in Patients With Gastroesophageal Reflux Disease. J Clin Gastroenterol. 2011;45(6):501-6. PubMed PMID: 20733514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Performance of narrow band imaging and magnification endoscopy in the prediction of therapeutic response in patients with gastroesophageal reflux disease. AU - Tseng,Ping-Huei, AU - Chen,Chien-Chuan, AU - Chiu,Han-Mo, AU - Liao,Wei-Chih, AU - Wu,Ming-Shiang, AU - Lin,Jaw-Town, AU - Lee,Yi-Chia, AU - Wang,Hsiu-Po, PY - 2010/8/25/entrez PY - 2010/8/25/pubmed PY - 2011/10/18/medline SP - 501 EP - 6 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 45 IS - 6 N2 - BACKGROUND: Imaging-enhanced endoscopy enhances the contrast of the mucosal surface and helps in the diagnosis of gastroesophageal reflux disease. However, whether the increased detection of subtle erosive foci corresponds to the effect of acid suppression remains elusive. GOALS: We aim to evaluate the utility of narrow band imaging with and without magnification endoscopy in the prediction of therapeutic response in patients with reflux. STUDY: Endoscopic evaluation with conventional white light, narrow band imaging, and narrow band imaging with magnification was performed sequentially in consecutive patients with reflux. All patients received proton pump inhibitor for 14 days. Their therapeutic responses were correlated with the baseline endoscopic findings, including mucosal breaks under standard endoscopy, mucosal brownish changes under narrow band imaging, and increased and/or dilated intrapapillary capillary loops or microerosions under narrow band imaging with magnification. RESULTS: Of a total of 82 patients, 22 (26.8%) patients were diagnosed with erosive disease under standard endoscopy. Among the remaining 60 (73.2%) patients, 14 (23.3%) and 30 (50%) were considered erosive under narrow band imaging and narrow band imaging with magnification, respectively. Sixty-five (79.3%) patients showed a positive therapeutic response. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting therapeutic response were 33.8%, 100%, 100%, 28.3%, and 47.6%, respectively, for standard endoscopy; 52.3%, 88.2%, 94.4%, 32.6%, and 59.8%, respectively, for narrow band imaging; and 70.8%, 64.7%, 88.4%, 36.6%, and 69.5%, respectively, for narrow band imaging with magnification. CONCLUSIONS: Narrow band imaging with and without magnification endoscopy substantially improve our ability to predict therapeutic response in patients with gastroesophageal reflux. SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/20733514/Performance_of_narrow_band_imaging_and_magnification_endoscopy_in_the_prediction_of_therapeutic_response_in_patients_with_gastroesophageal_reflux_disease_ L2 - http://dx.doi.org/10.1097/MCG.0b013e3181eeb115 DB - PRIME DP - Unbound Medicine ER -