Background:
A novel narrow band imaging (nbi) system is able to visualize the mucosal and vascular network in the gi tract.
Objective:
The aim of the current study was to test the feasibility of nbi to predict gastric histologic diagnosis.
Design:
A pilot feasibility study.
Setting:
Veterans affairs medical center.
Patients:
Forty-seven patients undergoing upper endoscopy for various indications were prospectively enrolled.
Methods:
The gastric body and antrum were systematically examined by nbi before targeted biopsies. images were graded according to the mucosal (ridge/villous and circular) and vascular patterns and correlated with histologic findings in a blinded manner.
Main outcome measurements:
Final histologic diagnosis based on updated sydney classification system.
Results:
Overall, 25 patients (53.1%) had a normal biopsy specimen, 13 (27.6%) had non-helicobacter pylori gastritis, 4 (8.5%) had h pylori gastritis, and 5 (10.6%) had intestinal metaplasia. the sensitivity, specificity, and positive predictive value of a regular mucosal and vascular pattern for the diagnosis of normal mucosa/mild gastritis were 89%, 78%, and 94%, respectively. the sensitivity and specificity of an irregular pattern with decreased density of vessels for the diagnosis of h pylori were 75% and 88%, and that of the ridge/villous pattern for the diagnosis of intestinal metaplasia were 80% and 100%, respectively.
Limitation:
The small number of patients with h pylori and intestinal metaplasia was the main limitation.
Conclusions:
This is the first u.s. study of nbi for gastric lesions. nbi may help predict in vivo histologic diagnosis of gastric pathologic conditions with a good degree of accuracy. future larger studies are needed.