TY - JOUR
T1 - Detection and classification of the mucosal and vascular patterns (mucosal morphology) in Barrett's esophagus by using narrow band imaging
AU - Kara, Mohammed A.
AU - Ennahachi, Mohamed
AU - Fockens, Paul
AU - ten Kate, Fiebo J. W.
AU - Bergman, Jacques J. G. H. M.
PY - 2006
Y1 - 2006
N2 - BACKGROUND: The detection of the mucosal morphology (ie, mucosal and vascular patterns) in Barrett's esophagus (BE) by magnifying (chromo)endoscopy may improve the distinction of high-grade intraepithelial neoplasia (HGIN) from nondysplastic specialized intestinal metaplasia (SIM). Narrow band imaging (NBI) is a new technique that uses optical filters to enhance the mucosal contrast without the need for chromoendoscopy. OBJECTIVE: To use NBI for the characterization and the classification of the mucosal morphology in nondysplastic BE and in BE with HGIN. DESIGN: Descriptive study. SETTING: Single-center study in a tertiary referral center for the diagnosis and treatment of patients with BE. PATIENTS: We used NBI with magnifying endoscopy to image and biopsy randomly selected areas in 63 patients with BE. A systematic image and a biopsy specimen evaluation process was followed, including unblinded assessment of an exploratory set of images and biopsy specimens, and blinded evaluation of learning and validation sets. MAIN OUTCOME MEASUREMENTS: The relationship between the mucosal morphology and the presence of SIM and HGIN. RESULTS: SIM was characterized by either villous/gyrus-forming patterns (80%), which were mostly regular and had regular vascular patterns, or a flat mucosa with regular normal-appearing long branching vessels (20%). HGIN was characterized by 3 abnormalities: irregular/disrupted mucosal patterns, irregular vascular patterns, and abnormal blood vessels. All areas with HGIN had at least 1 abnormality, and 85% had 2 or more abnormalities. The frequency of abnormalities showed a significant rise with increasing grades of dysplasia. The magnified NBI images had a sensitivity of 94%, a specificity of 76%, a positive predictive value of 64%, and a negative predictive value of 98% for HGIN. LIMITATIONS: No data on observer agreement. CONCLUSIONS: NBI with magnification reveals the mucosal morphology characteristics of nondysplastic BE and HGIN, without the need for staining and has a relatively high diagnostic value for HGIN when used for targeted detailed examination of areas of interest
AB - BACKGROUND: The detection of the mucosal morphology (ie, mucosal and vascular patterns) in Barrett's esophagus (BE) by magnifying (chromo)endoscopy may improve the distinction of high-grade intraepithelial neoplasia (HGIN) from nondysplastic specialized intestinal metaplasia (SIM). Narrow band imaging (NBI) is a new technique that uses optical filters to enhance the mucosal contrast without the need for chromoendoscopy. OBJECTIVE: To use NBI for the characterization and the classification of the mucosal morphology in nondysplastic BE and in BE with HGIN. DESIGN: Descriptive study. SETTING: Single-center study in a tertiary referral center for the diagnosis and treatment of patients with BE. PATIENTS: We used NBI with magnifying endoscopy to image and biopsy randomly selected areas in 63 patients with BE. A systematic image and a biopsy specimen evaluation process was followed, including unblinded assessment of an exploratory set of images and biopsy specimens, and blinded evaluation of learning and validation sets. MAIN OUTCOME MEASUREMENTS: The relationship between the mucosal morphology and the presence of SIM and HGIN. RESULTS: SIM was characterized by either villous/gyrus-forming patterns (80%), which were mostly regular and had regular vascular patterns, or a flat mucosa with regular normal-appearing long branching vessels (20%). HGIN was characterized by 3 abnormalities: irregular/disrupted mucosal patterns, irregular vascular patterns, and abnormal blood vessels. All areas with HGIN had at least 1 abnormality, and 85% had 2 or more abnormalities. The frequency of abnormalities showed a significant rise with increasing grades of dysplasia. The magnified NBI images had a sensitivity of 94%, a specificity of 76%, a positive predictive value of 64%, and a negative predictive value of 98% for HGIN. LIMITATIONS: No data on observer agreement. CONCLUSIONS: NBI with magnification reveals the mucosal morphology characteristics of nondysplastic BE and HGIN, without the need for staining and has a relatively high diagnostic value for HGIN when used for targeted detailed examination of areas of interest
U2 - https://doi.org/10.1016/j.gie.2005.11.049
DO - https://doi.org/10.1016/j.gie.2005.11.049
M3 - Article
C2 - 16860062
SN - 0016-5107
VL - 64
SP - 155
EP - 166
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 2
ER -