Narrow‐band imaging on screening of esophageal lesions using an ultrathin transnasal endoscopy

Kawai, Takashi; Takagi, Yu; Yamamoto, Kei; Hayama, Yasutaka; Fukuzawa, Mari; Yagi, Kenji; Fukuzawa, Masakatsu; Kataoka, Masao; Kawakami, Kohei; Itoi, Takao; Matsubayashi, Jun; Nagao, Toshitaka

doi:10.1111/j.1440-1746.2012.07068.x

Cited by 16 publications

(16 citation statements)

References 20 publications

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“…One study evaluated the methods in patients who already had a diagnosis of pre-malignant lesions or squamous cell carcinoma of the esophagus [31]. The other study evaluated the methods in the general population [27]. …”

Section: Resultsmentioning

confidence: 99%

Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis

et al. 2017

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BackgroundIn the early stage esophageal cancer, changes in the mucosa are subtle and pass unnoticed in endoscopic examinations using white light. To increase sensitivity, chromoscopy with Lugol’s solution has been used. Technological advancements have led to the emergence of virtual methods of endoscopic chromoscopy, including narrow band imaging (NBI). NBI enhances the relief of the mucosa and the underlying vascular pattern, providing greater convenience without the risks inherent to the use of vital dye. The purpose of this systematic review and meta-analysis was to evaluate the ability of NBI to diagnose squamous cell carcinoma of the esophagus and to compare it to chromoscopy with Lugol’s solution.MethodsThis systematic review included all studies comparing the diagnostic accuracy of NBI and Lugol chromoendoscopy performed to identify high-grade dysplasia and/or squamous cell carcinoma in the esophagus. In the meta-analysis, we calculated and demonstrated sensitivity, specificity, and positive and negative likelihood values in forest plots. We also determined summary receiver operating characteristic (sROC) curves and estimates of the areas under the curves for both per-patient and per-lesion analysis.ResultsThe initial search identified 7079 articles. Of these, 18 studies were included in the systematic review and 12 were used in the meta-analysis, for a total of 1911 patients. In per-patient and per-lesion analysis, the sensitivity, specificity, and positive and negative likelihood values for Lugol chromoendoscopy were 92% and 98, 82 and 37%, 5.42 and 1.4, and 0.13 and 0.39, respectively, and for NBI were 88 and 94%, 88 and 65%, 8.32 and 2.62, and 0.16 and 0.12, respectively. There was a statistically significant difference in only specificity values, in which case NBI was superior to Lugol chromoendoscopy in both analyses. In the per-patient analysis, the area under the sROC curve for Lugol chromoendoscopy was 0.9559. In the case of NBI, this value was 0.9611; in the per-lesion analysis, this number was 0.9685 and 0.9587, respectively.ConclusionsNBI was adequate in evaluating the esophagus in order to diagnose high-grade dysplasia and squamous cell carcinoma. In the differentiation of those disorders from other esophageal mucosa alterations, the NBI was shown to be superior than Lugol.

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Section: Resultsmentioning

confidence: 99%

Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis

et al. 2017

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“…Multiple prospective studies have shown that nonmagnified NBI examination is superior to WLI in detection of early esophageal lesions for screening of high-risk patients (10)(11)(12)(13) (15). In addition, NBI endoscopy also had a higher specificity comparing to Lugol chromoendoscopy (per lesion analysis 82% vs. 37%).…”

Section: Review Articlementioning

confidence: 99%

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Yip

Chiu

2017

J. Thorac. Dis.

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In recent years, diagnosis of early squamous cell carcinoma (SCC) of the esophagus has been increasingly emphasized. Utilization of image enhanced technology such as narrow band imaging (NBI) and magnification endoscopy allowed detailed examination of the esophageal mucosa. Different patterns of intrapapillary capillary loops (IPCL) have been proven to accurately diagnose and predict the depth of invasion of the tumors. In addition, the application of endoscopic submucosal dissection (ESD) has enabled safe en bloc resection of esophageal lesions. Promising results of ESD have been published and ESD is now the standard of therapy in early SCC of esophagus.

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“…In contrast, excellent detection rates for oesophageal and gastric cancers have previously been reported when using UT endoscopy in combination with chromoendoscopy using indigo carmine and iodine 64. It has also been suggested that if image enhancing techniques such as NBI (or FICE) can be applied through a UT endoscope, this may be useful in improving the detection of oesophageal premalignant lesions 65. This is now possible with the latest series of UT scopes.…”

Section: Gastric Cancermentioning

confidence: 99%

Transnasal endoscopy: no gagging no panic!

Parker

Alexandridis

Plevris

et al. 2015

Frontline Gastroenterol

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Background Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. Methods A Medline search was performed using the terms "transnasal", "ultrathin", "small calibre", "endoscopy", "EGD" to identify relevant literature. Results There is increasing evidence that TNE is better tolerated than standard endoscopy as measured using visual analogue scales, and the main area of discomfort is nasal during insertion of the TN endoscope, which seems remediable with adequate topical anaesthesia. The diagnostic yield has been found to be similar for detection of Barrett's oesophagus, gastric cancer and GORDassociated diseases. There are some potential issues regarding the accuracy of TNE in detecting small early gastric malignant lesions, especially those in the proximal stomach. TNE is feasible and safe in a primary care population and is ideal for screening for upper gastrointestinal pathology. It has an advantage as a diagnostic tool in the elderly and those with multiple comorbidities due to fewer adverse effects on the cardiovascular system. It has significant advantages for therapeutic procedures, especially negotiating upper oesophageal strictures and insertion of nasoenteric feeding tubes.Conclusions TNE is well tolerated and a valuable diagnostic tool. Further evidence is required to establish its accuracy for the diagnosis of early and small gastric malignancies. There is an emerging role for TNE in therapeutic endoscopy, which needs further study.

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Narrow‐band imaging on screening of esophageal lesions using an ultrathin transnasal endoscopy

Cited by 16 publications

References 20 publications

Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis

Narrow band imaging versus lugol chromoendoscopy to diagnose squamous cell carcinoma of the esophagus: a systematic review and meta-analysis

Endoscopic diagnosis and management of early squamous cell carcinoma of esophagus

Transnasal endoscopy: no gagging no panic!

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