Magnifying image-enhanced endoscopy-only mode boosted early cancer diagnostic efficiency: a multicenter randomized...

Area of Science:

• Gastroenterology
• Oncology
• Medical Imaging

Background:

• Magnifying image-enhanced endoscopy (MIEE) is an advanced endoscopic technique.
• Its effectiveness in improving cancer detection rates is not well-established.
• Preoperative examination is a key application area for MIEE.

Purpose of the Study:

• To evaluate the impact of MIEE on the detection rates of early gastric cancer and precancerous lesions.
• To compare the diagnostic performance of MIEE-only mode (o-MIEE), white-light endoscopy-only mode (o-WLE), and MIEE when necessary mode (n-MIEE).

Main Methods:

• An open-label, randomized, controlled trial was conducted across 6 hospitals in China.
• 5100 eligible patients aged ≥18 years undergoing gastroscopy were recruited.
• Participants were assigned to o-MIEE, o-WLE, or n-MIEE groups (1:1:1 ratio).

Main Results:

• The o-MIEE group detected significantly more early cancers (1.51%) compared to o-WLE (0.21%) and n-MIEE (0.43%) (P < .001).
• Positive predictive value (PPV) for early cancer was higher in o-MIEE (63.04%) versus o-WLE (33.33%) and n-MIEE (38.1%).
• A similar trend was observed for the detection of precancerous lesions.

Conclusions:

• The MIEE-only mode demonstrated a significant improvement in diagnosing early upper gastrointestinal cancer and precancerous lesions.
• MIEE is a valuable tool that can be utilized for opportunistic screening.
• The findings support the integration of MIEE into routine endoscopic examinations for enhanced diagnostic yield.