Usefulness of narrow-band imaging endoscopy for diagnosis of Barrett's esophagus.

Abstract

A newly developed endoscope lighting system called a narrow-band imaging system emphasizes certain histological features such as capillary and crypt pattern. The usefulness of NBI for the diagnosis of Barrett's esophagus (BE) was evaluated. Eleven patients with previously diagnosed BE were enrolled in this study. Magnifying endoscopy was performed by an experienced endoscopist, using both a conventional system and an NBI system. All images were recorded by video and by a digital still image filing system. Differences in images were evaluated by another experienced endoscopist. The quality of images for the visualization of the esophagogastric junction, capillary vessels, and columnar-lined esophagus (CLE) was judged as: optimal (score of 4), diagnostic (3), suboptimal (2), or nondiagnostic (1). In contrast to the low rate of visualization of the esophagogastric junction by conventional endoscopy, visualization of this area endoscopy was better by NBI. Net-like blood vessels were more clearly seen on images obtained by NBI endoscopy. Visualization of the CLE was better by NBI endoscopy than by conventional endoscopy. In contrast to conventional endoscopy, NBI endoscopy captured the optimal view of Barrett's epithelium. The relationship between the endoscopic and histopathologic diagnoses was more accurate by NBI endoscopy than by conventional endoscopy. Magnifying endoscopy by NBI is more useful than conventional magnifying endoscopy for the diagnosis of BE.