Magnification chromoendoscopy for the diagnosis of gastric intestinal metaplasia and dysplasia

Dinis-Ribeiro, Mário; Costa‐Pereira, Altamiro; Lopes, Carlos; Santos, Lúcio Lara; Guilherme, Mateus; Moreira‐Dias, Luís; Lomba‐Viana, Helena; Ribeiro, Augusto; Santos, Costa; Soares, José; Mesquita, Nuno; Silva, Rui; Lomba‐Viana, Rafael

doi:10.1067/mge.2003.145

Cited by 140 publications

(100 citation statements)

References 36 publications

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“…33 Magnifying images with methylene blue closely associate with histological findings and is useful not only for detecting gastric IM, but also for assessing its extent. 34,35 Narrow band imaging (NBI) system is obtained by using the specific filter that passes narrow banded blue and green lights, which are different from conventional red-green-blue filters (Fig. 12).…”

Section: Atrophic Gastritis In Magnifying Chromoendoscopy and Narrow mentioning

confidence: 99%

What Have We Accomplished in Endoscopic Image Analysis for Atrophic Gastritis?

Kim

Uedo

2013

Korean J Helicobacter Up Gastrointest Res

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Identifying precancerous conditions such as atrophic gastritis and intestinal metaplasia (IM) has a crucial role in detecting high risk patients for gastric cancer. White light imaging (WLI) is a basic tool for diagnosing these premalignant conditions, however its low accuracy and high variability has been a serious problem in diagnosing these premalignant conditions. Several noble imaging technologies, such as magnifying endoscopy, narrow band imaging, autofluorescence imaging, and confocal laser endomicroscopy, provids us with chances of overcoming the limitations of conventional WLI. Autofluorescence images help us understand the extent of atrophic gastritis with vivid colors. Magnifying endoscopy with narrow band imaging shows microsurface structure and micrvascular architecture and is able to identify the degree of intestinal metaplasia by the presence of "light blue crest" sign. Confocal laser endomicroscopy produces reliable images of goblet cells that can replace biopsy. Usefulness of the new endoscopic imaging techniques for predicting gastric cancer development needs to be validated in clinical practice. Currently, it would be practical to apply magnifying endoscopy with narrow band imaging sequentially after white light endoscopy for identifying the presence of IM and atrophic gastritis. (Korean J Helicobacter Up Gastrointest Res 2013;13:6-19)

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Section: Atrophic Gastritis In Magnifying Chromoendoscopy and Narrow mentioning

confidence: 99%

What Have We Accomplished in Endoscopic Image Analysis for Atrophic Gastritis?

Kim

Uedo

2013

Korean J Helicobacter Up Gastrointest Res

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“…A transparent tip attachment (D-201-11802; Olympus) projecting 2 mm from the endoscopic tip was pressed against the mucosa in order to maintain good focus. To decrease the influence of mucus in the stomach under magnified observation, all patients ingested simethicone (20-30 mL), and a mucolytic agent (10% N-acetylcysteine 20 to 30 mL) was sprayed on the mucosal surface [4] . Evaluation of the entire stomach was initially performed with conventional endoscopy (CE) to exclude obvious lesions and to define scar lesions.…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, ME procedures for the upper gastrointestinal tract have been developed that make it possible to perform a variety of assessments, from routine observation to a detailed examination of squamous dysplasia, squamous-cell carcinoma, Barrett's esophagus and associated dysplasia/early cancer, gastric cancer, and Helicobacter pylori infection [2][3][4] . ME with a narrow band image can aid in deciding the target of endoscopic biopsy for surveillance in Barrett's esophagus [5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

Lee¹,

Chung²,

Park³

et al. 2009

WJG

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AIM:To investigate the relationship between postendoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME. From January, 2007 to June, 2008 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies. METHODS: RESULTS:CE findings showed nodular scars (53/129), erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (Ⅰ) 47 round; (Ⅱ) 54 short rod or tubular; (Ⅲ) 19 branched or gyrus-like; and (Ⅳ) 9 destroyed pits. Sensitivity and specificity were 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type Ⅳ pit patterns were diagnosed as tumor lesions, and 120 cases of type Ⅰ-Ⅲ pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%. CONCLUSION: ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.

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“…In an earlier trial, the sensitivity of magnification chromoendoscopy using methylene blue was 76% for IM, and 97% for dysplasia [25] , compared to rates less than 50% for conventional endoscopy [26] . In a Dutch study of 36 patients with premalignant gastric lesions, the sensitivity of NBI versus white light endoscopy for detection of IM or dysplasia was 71% versus 51% respectively (p<0.001), compared to random and targeted biopsies [27] .…”

Section: Surveillance Of Gastric Intestinal Metaplasia: Is It Warranted?mentioning

confidence: 99%

Surveillance of Gastric Intestinal Metaplasia: Is It Warranted?

Galiatsatos

2014

Journal of Gastroenterology and Hepatology Research

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Despite a decline in incidence over time, gastric adenocarcinoma remains one of the most common and lethal malignancies worthwhile. Nonetheless, endoscopic surveillance of gastric intestinal metaplasia (IM), a precursor lesion, remains controversial with lack of uniform guidelines. Trials have shown a roughly 6-fold increased risk of gastric cancer in the context of IM, with evidence of earlier stage detection and improved 5-year survival with routine surveillance protocols. Thorough pursuit and treatment of Helicobacter pylori infection seems warranted, as IM severity scores appear to improve post eradication. Conventional and digital chromoendoscopy may be the way of the future, while appropriate and cost-effective intervals for surveillance still need to be determined.

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Magnification chromoendoscopy for the diagnosis of gastric intestinal metaplasia and dysplasia

Cited by 140 publications

References 36 publications

What Have We Accomplished in Endoscopic Image Analysis for Atrophic Gastritis?

What Have We Accomplished in Endoscopic Image Analysis for Atrophic Gastritis?

Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

Surveillance of Gastric Intestinal Metaplasia: Is It Warranted?

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