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Updated: Apr 1, 2026

Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
A multicenter randomized comparison between high-definition white light endoscopy and narrow band imaging for
Tiing Leong Ang1, Rapat Pittayanon, James Yun Wong Lau
1aDepartment of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore bDivision of Gastroenterology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand cDepartment of Surgery, Chinese University of Hong Kong, Hong Kong, China dDepartment of Medicine, University of Malaya, Kuala Lumpur, Malaysia eDepartment of Gastroenterology, Lyell McEwin Hospital, Adelaide, Australia.
Objective:
Narrow band imaging (NBI) is generally considered to be useful for lesion characterization, but not enhanced detection of gastric lesions, because of the dark endoscopic view. We tested whether the new generation of NBI (190-NBI or 290-NBI), which is twice as bright as the previous version, would improve detection of premalignant gastric lesions compared with high-definition white light endoscopy (HD-WLE).
Patients And Methods:
This was a multicenter prospective randomized study involving five tertiary institutions in the Asia-Pacific region. A total of 579 patients aged older than 50 years who underwent diagnostic upper gastrointestinal endoscopy were randomized to either HD-WLE or NBI. The outcome measurements were detection of intestinal metaplasia (IM), focal gastric lesions, and gastric cancers.
Results:
Focal gastric lesions were detected in 83/286 (29%) and 119/293 patients (40.6%) by HD-WLE and by NBI, respectively (P=0.003). IM was detected in 22/286 patients (7.7%) by HD-WLE and in 52/293 patients (17.7%) by NBI (P<0.001). Gastric cancer were found in 7/286 (2.4%) and 3/293 patients (1%) in HD-WLE and NBI groups, respectively (P=0.189).
Conclusion:
NBI increased the detection rate of IM compared with HD-WLE.
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