Tags

Type your tag names separated by a space and hit enter

Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study.
Gastrointest Endosc 2019; 89(4):749-758GE

Abstract

BACKGROUND AND AIMS

Endoscopic features of early neoplasia in Barrett's esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett's neoplasia.

METHODS

Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores).

RESULTS

Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01).

CONCLUSIONS

BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone. (ISRCTN registry study ID: ISRCTN15916689.).

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands.Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands.Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.Gastroenterology and Interventional Endoscopy, Krankenhaus Barmherzige Brüder, Regensburg, Germany.Center of Internal Medicine, Ulm University, Ulm, Germany.Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands.Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30419218

Citation

de Groof, Albert J., et al. "Blue-light Imaging Has an Additional Value to White-light Endoscopy in Visualization of Early Barrett's Neoplasia: an International Multicenter Cohort Study." Gastrointestinal Endoscopy, vol. 89, no. 4, 2019, pp. 749-758.
de Groof AJ, Swager AF, Pouw RE, et al. Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study. Gastrointest Endosc. 2019;89(4):749-758.
de Groof, A. J., Swager, A. F., Pouw, R. E., Weusten, B. L. A. M., Schoon, E. J., Bisschops, R., ... Bergman, J. J. G. H. M. (2019). Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study. Gastrointestinal Endoscopy, 89(4), pp. 749-758. doi:10.1016/j.gie.2018.10.046.
de Groof AJ, et al. Blue-light Imaging Has an Additional Value to White-light Endoscopy in Visualization of Early Barrett's Neoplasia: an International Multicenter Cohort Study. Gastrointest Endosc. 2019;89(4):749-758. PubMed PMID: 30419218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study. AU - de Groof,Albert J, AU - Swager,Anne-Fré, AU - Pouw,Roos E, AU - Weusten,Bas L A M, AU - Schoon,Erik J, AU - Bisschops,Raf, AU - Pech,Oliver, AU - Meining,Alexander, AU - Neuhaus,Horst, AU - Curvers,Wouter L, AU - Bergman,Jacques J G H M, Y1 - 2018/11/09/ PY - 2018/08/08/received PY - 2018/10/24/accepted PY - 2018/11/13/pubmed PY - 2019/9/17/medline PY - 2018/11/13/entrez SP - 749 EP - 758 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 89 IS - 4 N2 - BACKGROUND AND AIMS: Endoscopic features of early neoplasia in Barrett's esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett's neoplasia. METHODS: Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores). RESULTS: Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01). CONCLUSIONS: BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone. (ISRCTN registry study ID: ISRCTN15916689.). SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/30419218/Blue_light_imaging_has_an_additional_value_to_white_light_endoscopy_in_visualization_of_early_Barrett's_neoplasia:_an_international_multicenter_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(18)33259-0 DB - PRIME DP - Unbound Medicine ER -