Differential diagnosis of superficial duodenal epithelial tumor and non-neoplastic lesion in duodenum by magnified endoscopic examination with image-enhanced endoscopy

Use of magnifying endoscopy with narrow‐band imaging can change the clinical practice of screening endoscopy for early upper gastrointestinal neoplasia

“…Endoscopic diagnosis of early upper gastrointestinal (GI) neoplasia comprises two steps: detection and characterization 1 . Magnifying endoscopy with narrow‐band imaging (M‐NBI) is more useful than conventional white‐light imaging (C‐WLI) for detecting and/or characterizing early GI neoplasia in the oropharynx, esophagus, stomach, and duodenum 2–5 . The key findings reported and the methods for detection and characterization differ depending on the organ.…”

“…However, M-NBI can be a powerful tool for the characterization of SNADET, with a sensitivity and specificity of 88.4% and 98.4%, respectively, for differentiating between neoplasia and nonneoplasia according to an algorithm. 5 According to the VS classification system for nonbiopsied lesions, the sensitivity and specificity of M-NBI were 95% and 70%, respectively, for…”

“…No specific reports have described the diagnostic performance of C‐WLI in detecting superficial nonampullary duodenal epithelial tumors (SNADETs). However, M‐NBI can be a powerful tool for the characterization of SNADET, with a sensitivity and specificity of 88.4% and 98.4%, respectively, for differentiating between neoplasia and nonneoplasia according to an algorithm 5 . According to the VS classification system for nonbiopsied lesions, the sensitivity and specificity of M‐NBI were 95% and 70%, respectively, for differentiating SNADET from low‐grade adenoma and high‐grade adenoma/cancer 7 .…”

“…1 Magnifying endoscopy with narrow-band imaging (M-NBI) is more useful than conventional white-light imaging (C-WLI) for detecting and/or characterizing early GI neoplasia in the oropharynx, esophagus, stomach, and duodenum. [2][3][4][5] The key findings reported and the methods for detection and characterization differ depending on the organ. In the oropharynx and esophagus, a well-demarcated brownish area on nonmagnifying endoscopy with NBI is a marker for detecting early squamous cell carcinoma, and an irregular microvascular pattern is a marker of characterization on M-NBI.…”

White opaque substance in a non‐neoplastic duodenal lesion

“…An endoscopic diagnosis algorithm using magnifying narrow-band imaging (M-NBI) was proposed for tumorous lesions in the duodenum to differentiate between neoplasms and non-neoplasms. 1,2 Two patterns called "openloop structure" and "closed-loop structure" 2 can be observed by M-NBI.…”