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 22 February 2018

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News

Comparing techniques for diagnosis of Barrett's esophagus

This month's Gastroenterology compares chromoendoscopy and narrow-band imaging compared with high-resolution magnification endoscopy in Barrett's.

News image

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Dr Wouter Curvers and colleagues from the Netherlands compared magnified still images obtained with high-resolution white light endoscopy, indigo carmine chromoendoscopy, acetic acid chromoendoscopy, and narrow-band imaging.

The research team determined the best technique for use in Barrett's esophagus.

The researchers obtained magnified images from 22 areas with the 4 aforementioned techniques.

The team reported that 7 endoscopists with no specific expertise in Barrett's esophagus or advanced imaging techniques evaluated these areas.

The yield for identifying early neoplasia with white light images was 86% for all observers
Gastroenterology

Of these, 5 were international experts in this field who evaluated these 22 areas for overall image quality, mucosal image quality, and vascular image quality.

In addition, the regularity of mucosal and vascular patterns and the presence of abnormal blood vessels were evaluated.

This was correlated with histology.

The interobserver agreement for the 3 features of mucosal morphology with white light images ranged from κ = 0.51 to κ = 0.53 for all observers.

The team noted that the interobserver agreement ranged from κ = 0.43 to κ = 0.53 for experts, and from κ = 0.51 to κ = 0.64 for nonexperts.

The interobserver agreement in these groups did not improve by adding one of the enhancement techniques.

The team found that the yield for identifying early neoplasia with white light images was 86% for all observers, 90% for experts, and 84% for nonexperts.

The addition of enhancement techniques did not improve the yield neoplasia.

Dr Curvers' team commented, "The addition of indigo carmine chromoendoscopy, acetic acid chromoendoscopy, or narrow-band imaging to white light images did not improve interobserver agreement or yield identifying early neoplasia in Barrett's esophagus."

Gastroenterology 2008: 134(3): 670-9
10 March 2008

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