Irregular arrangement of collecting venules (IRAC) provides a critical endoscopic insight in Helicobacter pylori-induced gastritis: A secondary publication

Katake, Yoshiki; Ichikawa, Kazuhito; Fujio, Chikau; Tomita, Shigeki; Imura, Johji; Fujimori, Takahiro

doi:10.3892/br.2012.8

Cited by 12 publications

(5 citation statements)

References 23 publications

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“…[8][9][10] This may approach 100% when the stomach is examined with image enhancement, such as NBI. [11][12][13] Different types of abnormal RAC pattern have been described 14 ; this study has attempted to simplify the diagnostic process by specifying only the presence or absence of the normal RAC, when examined without magnification using both white light and NBI.…”

Section: Discussionmentioning

confidence: 99%

Assessment ofHelicobacter pyloristatus by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Glover

Teare

Patel

2021

BMJ Open Gastroenterol

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ObjectivesHelicobacter pylori infection is a common cause of chronic gastritis worldwide and an established risk factor for developing gastric malignancy. The endoscopic appearances predicting H. pylori status are an ongoing area of research, as are their diagnostic accuracies. This study aimed to establish the diagnostic accuracy of several mucosal features predictive of H. pylori negative status and formulate a simple prediction model for use at the time of endoscopy.DesignPatients undergoing high-definition upper gastrointestinal (GI) endoscopy without magnification were recruited prospectively. During the endoscopy, the presence or absence of specific endoscopic findings was noted. Sydney protocol biopsies were used as the diagnostic reference standard, and urease test if taken. The results informed a logistic regression model used to produce a simple diagnostic approach. This model was subsequently validated using a further cohort of 30 patients.Results153 patients were recruited and completed the study protocol. The prevalence of active H. pylori infection was 18.3% (28/153). The overall diagnostic accuracy of the simple prediction model was 80.0%, and 100% of patients with active H. pylori infection were correctly classified. The presence of regular arrangement of collecting venules (RAC) showed a positive predictive value for H. pylori naïve status of 90.7%, rising to 93.6% for patients under the age of 60.ConclusionA simple endoscopic model may be accurate for predicting H. pylori status of a patient, and the need for biopsy-based tests. The presence of RAC in the stomach is an accurate predictor of H. pylori negative status, particularly in patients under the age of 60.Trial registration numberThe study was registered with ClinicalTrials.gov, No. NCT02385045.

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Section: Discussionmentioning

confidence: 99%

Assessment ofHelicobacter pyloristatus by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Glover

Teare

Patel

2021

BMJ Open Gastroenterol

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“…In the last years, the advances in endoscopic technology have allowed for a better observation of the gastric mucosa, even without magnifying endoscopy, and numerous endoscopic features have been associated with the presence of H. pylori infection [9,10]. Among all of them, the presence of a regular arrangement of collecting venules (RAC) is one of the most reliable features, with a sensitivity and negative predictive value (NPV) higher than 90% for the diagnosis of H. pylori-negative mucosa [11][12][13][14]. Although most of these studies have been conducted in Asia, using magnifying endoscopes [15], results from a recent study performed in Europe, with high definition (HD) endoscopes without magnification, showed a sensitivity and NPV of 100% [10].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Helicobacter pylori Infection by the Arrangement of Collecting Venules Using White Light Endoscopy: Evaluation of Interobserver Agreement

Garcés-Durán

Galdin-Ferreyra

Delgado-Guillena

et al. 2021

Dig Dis

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Background: Regular arrangement of collecting venules (RAC) in gastric mucosa accurately identifies patients without Helicobacter pylori (H pylori) infection. The aim of our study was to evaluate the reproducibility of RAC using white light endoscopy without magnification, in a European country, and to assess the impact of proton pump inhibitors (PPIs). Methods: A multicenter prospective study with image capture of the distal lesser gastric curvature and gastric biopsies was performed. The presence of starfish-like minute points regularly distributed throughout lesser curvature was considered as RAC positive (RAC+). A set of 20 images was used for the training phase and inter and intra-observer agreements were calculated. Results: 174 patients were included and 85 (48.9%) were taking PPIs. Kappa values for interobserver and intra-observer agreements were substantial (0.786) and excellent (0.906), respectively. H. pylori infection was diagnosed in 29 patients (16.7%): 10/85 with PPIs and 19/89 without PPIs (11.8% vs. 21.3%; p = 0.09). All RAC + patients were free of H. pylori infection, with a sensitivity and negative predictive value of 100%, regardless of PPI intake. Conclusion: The endoscopic diagnosis of H. pylori by RAC is an easy-to-learn and highly reproducible technique, even with PPI intake. Our results warrant RAC as a real-time diagnostic method for H. pylori-negative infection in Western practice.

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“…As a result, 34 articles were ultimately included in the meta-analysis. 10 , 11 , 13 , 14 , 20 , 24 - 52 Fig. 1 shows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart of this process.…”

Section: Resultsmentioning

confidence: 99%

The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

Lee,

Yoo,

Yeniova

et al. 2023

Gut and Liver

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Background/Aims Recognizing Helicobacter pylori infection during endoscopy is important because it can lead to the performance of confirmatory testing. Linked color imaging (LCI) is an image enhancement technique that can improve the detection of gastrointestinal lesions. The purpose of this study was to compare LCI to conventional white light imaging (WLI) in the endoscopic diagnosis of H. pylori infection. Methods We conducted a comprehensive literature search using PubMed, Embase, and the Cochrane Library. All studies evaluating the diagnostic performance of LCI or WLI in the endoscopic diagnosis of H. pylori were eligible. Studies on magnifying endoscopy, chromoendoscopy, and artificial intelligence were excluded. Results Thirty-four studies were included in this meta-analysis, of which 32 reported the performance of WLI and eight reported the performance of LCI in diagnosing H. pylori infection. The pooled sensitivity and specificity of WLI in the diagnosis of H. pylori infection were 0.528 (95% confidence interval [CI], 0.517 to 0.540) and 0.821 (95% CI, 0.811 to 0.830), respectively. The pooled sensitivity and specificity of LCI in the diagnosis of H. pylori were 0.816 (95% CI, 0.790 to 0.841) and 0.868 (95% CI, 0.850 to 0.884), respectively. The pooled diagnostic odds ratios of WLI and LCI were 15.447 (95% CI, 8.225 to 29.013) and 31.838 (95% CI, 15.576 to 65.078), respectively. The areas under the summary receiver operating characteristic curves of WLI and LCI were 0.870 and 0.911, respectively. Conclusions LCI showed higher sensitivity in the endoscopic diagnosis of H. pylori infection than standard WLI.

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Irregular arrangement of collecting venules (IRAC) provides a critical endoscopic insight in Helicobacter pylori-induced gastritis: A secondary publication

Cited by 12 publications

References 23 publications

Assessment ofHelicobacter pyloristatus by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Assessment ofHelicobacter pyloristatus by examination of gastric mucosal patterns: diagnostic accuracy of white-light endoscopy and narrow-band imaging

Diagnosis of <b><i>Helicobacter pylori</i></b> Infection by the Arrangement of Collecting Venules Using White Light Endoscopy: Evaluation of Interobserver Agreement

The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis

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