Reliability and accuracy of blue light imaging for staging of intestinal metaplasia in the stomach

Castro, Raquel; Rodríguez, Marta; Libânio, Diogo; Esposito, Gianluca; Pita, Inês; Patita, Marta; Costa-Santos, Cristina; Pimentel‐Nunes, Pedro; Dinis-Ribeiro, Mário

doi:10.1080/00365521.2019.1684555

Cited by 23 publications

(13 citation statements)

References 22 publications

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“…25 Moreover, IEE was used for evaluation of IM instead of WLI because the sensitivity of IEE for diagnosing gastric IM is higher than that of WLI. [8][9][10]17 Using the strength of these endoscopic findings in multivariate ways, we developed a modified Kyoto classification scoring system for predicting GC risk. The usefulness of the modified Kyoto classification scoring system was evaluated using receiver operating characteristic curve analysis, and the area under the receiver operating characteristic curve (AUC) was compared with other risk stratification methods.…”

Section: Evaluation Of Endoscopic Findings and Development Of A Modif...mentioning

confidence: 99%

“…2 The operative link on gastritis assessment (OLGA) 3 and the operative link on gastric intestinal metaplasia assessment (OLGIM) 4 staging systems using biopsy specimens were commonly used for histological assessment of GC risk. [5][6][7] With technical advance of image-enhanced endoscopy (IEE), recent Western studies have demonstrated IEE has high accuracy for diagnosis of histological IM without biopsies 8,9 and usefulness for risk assessment of GC according to the endoscopic grading of gastric intestinal metaplasia (EGGIM) scoring system. [10][11][12] In Japan, the Kyoto classification of gastritis using conventional white light image (WLI) endoscopy findings related to H. pylori gastritis was proposed.…”

Section: Introductionmentioning

confidence: 99%

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Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: Multicenter observation study in Japan

Kawamura

Uedo

Koike

et al. 2021

Digestive Endoscopy

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Objectives: The usefulness of endoscopic and histological risk assessment for gastric cancer (GC) has not been fully investigated in Japanese clinical practice. Methods:In this multicenter observation study, GC and non-GC patients were prospectively enrolled in 10 Japanese facilities. The Kyoto classification risk scoring system, the Kimura-Takemoto endoscopic atrophy classification, the endoscopic grading of gastric intestinal metaplasia (EGGIM), the operative link on gastritis assessment (OLGA) and the operative link on gastric intestinal metaplasia assessment (OLGIM) were applied to all patients. The strength of an association with GC risk was compared. In addition, important endoscopic findings in the Kyoto classification were identified.Results: Overall, 115 GC and 265 non-GC patients were analyzed. Each risk stratification method had a significant association with GC risk in univariate analysis. In multivariate analysis, OLGIM stage III/IV (odds ratio [OR] 2.8 [95% CI 1.5-5.3]), high EGGIM score (OR 1.8 [1.0-3.1]) and opened-type Kimura-Takemoto (OR 2.5 [1.4-4.5]) had significant associations with GC risk. In the Kyoto classification, opened-type endoscopic atrophy, invisible regular arrangement of collecting venules (RAC), extensive (>30%) intestinal metaplasia in the corpus in image-enhanced endoscopy, and map-like redness in the corpus were independent high-risk endoscopic findings. The modified Kyoto classification risk scoring system using these four findings demonstrated a better area under the receiver operating characteristic curve value (0.750, P = 0.052) than that of the original Kyoto classification (0.706). Conclusions:The OLGIM stage III/IV, high EGGIM score and open-typed Kimura-Takemoto had strong association with GC risk in Japanese patients. The modified Kyoto classification risk scoring system may be useful for GC risk assessment, which warrants further validation. (UMIN000027023).

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Section: Evaluation Of Endoscopic Findings and Development Of A Modif...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: Multicenter observation study in Japan

Kawamura

Uedo

Koike

et al. 2021

Digestive Endoscopy

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“…Similar observations were reported in other studies[ 5 , 16 ]. As WLE cannot adequately predict the presence of GIM[ 17 ],which may lead to missed diagnosis of some early cancers and precancerous lesions. Another study suggested a very poor correlation between WLE endoscopic manifestations and histopathological diagnosis[ 18 ], consistent with our WLE results of correct diagnosis in 27 along with misjudgment in 58 patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of white-light endoscopy, optical-enhanced and acetic-acid magnifying endoscopy for detecting gastric intestinal metaplasia: A randomized trial

Song¹,

Xu²,

Xing³

et al. 2021

WJCC

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BACKGROUND Gastric intestinal metaplasia (GIM) is a precancerous lesion of the stomach, which severely affects human life and health. Currently, a variety of endoscopic techniques are used to screen/evaluate GIM. Traditional white-light endoscopy (WLE) and acetic-acid chromoendoscopy combined with magnifying endoscopy (ME-AAC) are the interventions of choice due to their diagnostic efficacy for GIM. Optical-enhanced magnifying endoscopy (ME-OE) is a new virtual chromoendoscopy technique to identify GIM, which combines bandwidth-limited light and image enhancement processing technology to enhance the detection of mucosal and vascular details. We hypothesized that ME-OE is superior to WLE and ME-AAC in the evaluation of GIM. AIM To directly compare the diagnostic value of WLE, ME-AAC, and ME-OE for detection of GIM. METHODS A total of 156 patients were subjected to consecutive upper gastrointestinal endoscopy examinations using WLE, ME-AAC, and ME-OE. Histopathological findings were utilized as the reference standard. Accuracy, sensitivity, specificity, and positive and negative predictive values of the three endoscopy methods in the diagnosis of GIM were evaluated. Moreover, the time to diagnosis with ME-AAC and ME-OE was analyzed. Two experts and two non-experts evaluated the GIM images diagnosed using ME-OE, and diagnostic accuracy and intra- and inter-observer agreement were analyzed. RESULTS GIM was detected in 68 of 156 patients (43.6%). The accuracy of ME-OE was highest (91.7%), followed by ME-AAC (86.5%), while that of WLE (51.9%) was lowest. Per-site analysis showed that the overall diagnostic accuracy of ME-OE was higher than that of ME-AAC ( P = 0.011) and WLE ( P < 0.001). The average diagnosis time was lower in ME-OE than in ME-AAC (64 ± 7 s vs 151 ± 30 s, P < 0.001). Finally, the inter-observer agreement was strong for both experts ( k = 0.862) and non-experts ( k = 0.800). The internal consistency was strong for experts ( k = 0.713, k = 0.724) and moderate for non-experts ( k = 0.667, k = 0.598). CONCLUSION For endoscopists, especially experienced endoscopists, ME-OE is an efficient, convenient, and time-saving endoscopic technique that should be used for the diagnosis of GIM.

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“…Although some studies reported comparable results between BLI and NBI, they were performed under high magnification, and mostly in Eastern countries. A recent study also reported excellent results with BLI without high magnification to diagnose GIM [73]; nevertheless, more studies evaluating BLI without high magnification, especially in Western countries, are needed to reach definite conclusions.…”

Section: Covariatesmentioning

confidence: 99%

Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis

et al. 2020

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Background Image-enhanced endoscopy (IEE) improves the accuracy of endoscopic diagnosis. We aimed to assess the value of IEE for gastric preneoplastic conditions and neoplastic lesions. Methods Medline and Embase were searched until December 2018. Studies allowing calculation of diagnostic measures were included. Risk of bias and applicability were assessed using QUADAS-2. Subgroup analysis was performed to explore heterogeneity. Results 44 studies met the inclusion criteria. For gastric intestinal metaplasia (GIM), narrow-band imaging (NBI) obtained a pooled sensitivity and specificity of 0.79 (95 %CI 0.72–0.85) and 0.91 (95 %CI 0.88–0.94) on per-patient basis; on per-biopsy basis, it was 0.84 (95 %CI 0.81–0.86) and 0.95 (95 %CI 0.94–0.96), respectively. Tubulovillous pattern was the most accurate marker to detect GIM and it was effectively assessed without high magnification. For dysplasia, NBI showed a pooled sensitivity and specificity of 0.87 (95 %CI 0.84–0.89) and 0.97 (95 %CI 0.97–0.98) on per-biopsy basis. The use of magnification improved the performance of NBI to characterize early gastric cancer (EGC), especially when the vessel plus surface (VS) classification was applied. Regarding other technologies, trimodal imaging also obtained a high accuracy for dysplasia (sensitivity 0.93 [95 %CI 0.85–0.98], specificity 0.98 [95 %CI 0.92–1.00]). For atrophic gastritis, no specific pattern was noted and none of the technologies reached good diagnostic yield. Conclusion NBI is highly accurate for GIM and dysplasia. The presence of tubulovillous pattern and the VS classification seem to be useful to detect GIM and characterize EGC, respectively. These features should be used in current practice and to standardize endoscopic criteria for other technologies.

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Reliability and accuracy of blue light imaging for staging of intestinal metaplasia in the stomach

Cited by 23 publications

References 22 publications

Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: Multicenter observation study in Japan

Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: Multicenter observation study in Japan

Comparison of white-light endoscopy, optical-enhanced and acetic-acid magnifying endoscopy for detecting gastric intestinal metaplasia: A randomized trial

Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis

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