Magnification endoscopy with contrast enhancement has been reported to be highly accurate in predicting specialized intestinal metaplasia (SIM) in Barrett’s esophagus.
However, there have been no published studies on inter- and intra-observer variability.
In this study, doctors from Munich, Germany, prospectively evaluated 51 patients with reflux symptoms.
The patients underwent magnification endoscopy. The team recorded video sequences in both standard and zoom modes before and after the instillation of 1.5% acetic acid or staining with 0.5% methylene blue.
Biopsies were also obtained.
The 102 video sequences were shown to 4 experienced endoscopists.
|61% of the patients had histologically detectable specialized intestinal metaplasia.|
The doctors found that there was a high level of interobserver variability among the four examiners.
Overall, the team determined that 61% of the patients had histologically detectable SIM.
However, the accuracy of all examiners for predicting SIM by magnification endoscopy was around 50%.
The doctors found no differences before and after instillation of acetic acid or methylene blue staining.
Dr Meining's team concluded, "The suggested criteria for identifying SIM using magnification endoscopy are associated with a high level of interobserver variability".
"When evaluated in a blinded manner, staining techniques do not significantly improve the yield for detecting SIM at the esophagogastric junction".