Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions

Abstract

Narrow band imaging (NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy (NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists.

Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphomas: A review

“…Recently, the usefulness of magnifying endoscopy in detecting gastrointestinal lesions has been given attention [39] , and magnifying endoscopy with narrowband imaging (MNBI) is proposed to be a useful technique to diagnose gastric MALT lymphomas [32,40,41] . Interestingly, Nonaka et al [41] reported that MNBI was useful in not only detecting gastric MALT lymphomas but also in evaluating their response to eradication therapy.…”

Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy

“…On the other hand, in neoplastic lesions the abnormal mucosal and capillary patterns have characteristic features. In squamous neoplastic lesions, IPCLs exhibit characteristic morphological changes, being dilated, tortuous, and irregular in dysplastic lesions, and destructed and replaced by tumor vessels in squamous cell carcinomas (SCCs) [1, 10, 11]. Likewise, in BE a circular and “ridged/villous” pattern with regular vessels is predictive of specialized intestinal metaplasia, and irregular mucosal and vessel patterns are predictive of dysplasia [1, 9].…”

“…Magnification endoscopy with NBI (ME-NBI) also allows a better visualization of normal capillary mucosal vessels (intraepithelial papillary capillary loops [IPCLs]) and submucosal vascularity (branching vessels) [1, 10]. Normal IPCLs are observed as brown loops originating from a branching vessel, running perpendicularly in the lamina propria and finally reaching the intraepithelial papillae (Fig.…”

Etiology and Prevention of Gastric Cancer

“…The data from five case-control studies and two cohort studies in Japan demonstrated that photofluoroscopy for gastric cancer screening can decrease gastric cancer mortality by 40-60% [12]. By now, many new advanced approaches providing better visualization of gastric mucosa lesions have been developed, such as chromoendoscopy [62], confocal laser endomicroscopy [63], narrow-band imaging endoscopy [64], magnifying endoscopy [65] and narrow-band imaging with magnifying endoscopy [66]. A large number of studies showed that these new advanced endoscopic imaging technologies have better accuracy for diagnosing premalignant gastric lesions than standard ‘white light' endoscopy [67,68,69].…”