In contrast to standard video endoscopy, magnifying endoscopy after local acetic acid application enables recognition of mucosal surface architecture.
Dr Hoffman and colleagues from Germany investigated the diagnostic yield of magnifying endoscopy with acetic acid-targeted biopsies vs 4-quadrant biopsies.
The investigative team conducted a prospective randomized trial with crossover design.
The team randomized patients to undergo either standard video endoscopy with 4-quadrant biopsies or magnifying endoscopy with acetic acid application.
All patients were re-examined 14 days after the initial endoscopy with the corresponding procedure.
|Magnifying endoscopy predicted Barrett's epithelium with a sensitivity of 100%|
The investigators' primary outcome analysis was the histological proof of Barrett's epithelium.
The team also assessed the correlation between the presence of Barrett's epithelium and the needed number of biopsies to confirm Barrett's epithelium for the 2 different procedures.
Magnifying endoscopy enabled the prediction of Barrett's epithelium with a sensitivity of 100% and a specificity of 66%, respectively.
The investigators found that acetic acid-guided biopsies obtained 78% of tissues containing Barrett's epithelium compared to 57% with random biopsies.
Dr Hoffman's team concludes, “Magnifying endoscopy with acetic acid-guided biopsies is superior to standard video endoscopy with random biopsies.”
“The number of biopsies needed to confirm Barrett's epithelium is half as much when compared to random biopsies.”