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Updated: May 27, 2025
Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
Optical enhancement with magnification versus white-light endoscopy for detecting gastric intestinal metaplasia and
Meng Wan1, Guang-Chao Li1, Ming-Jun Ma1
1Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China; Shandong Provincial Clinical Research Center for Digestive Disease, Jinan, China; Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China; Robot Engineering Laboratory for Precise Diagnosis and Therapy of GI Tumor, Qilu Hospital of Shandong University, Jinan, China.
Background And Aims:
The detection of gastric intestinal metaplasia (GIM), gastric intraepithelial neoplasia (GIN), and early gastric cancer (EGC) using white-light endoscopy (WLE) is unsatisfactory. This study assessed the value of optical enhancement combined with magnification endoscopy (ME-OE) versus WLE for detecting GIM, GIN, and EGC.
Methods:
Patients at high risk for gastric cancer were randomly assigned to the ME-OE group or WLE group at a 1:1 ratio. Suspicious GIM, GIN, and EGC lesions underwent targeted biopsy sampling in both groups. The diagnostic yield, diagnostic efficacy, and agreement of suspicious lesions were compared between the 2 groups.
Results:
Two hundred eighty-five patients were finally analyzed. The per-patient diagnostic yields of GIM, GIN, and EGC were 36.6% in the ME-OE group and 23.8% in the WLE group (P = .018). The per-lesion diagnostic yield of GIM, GIN, and EGC in the ME-OE group was higher than that in the WLE group (66.7% vs 48.7%, P = .017). Sensitivity (82.8% vs 54.3%, P = .003), specificity (84.2% vs 81.4%, P = .738), positive predictive value (88.9% vs 70.4%, P = .038), negative predictive value (76.2% vs 68.6%, P = .419), and accuracy (83.3% vs 69.2%, P = .028) for GIM were compared between the 2 groups. The intraobserver agreements of experienced endoscopists were excellent for ME-OE (κ = 0.81 and κ = 0.83) and good for WLE (κ = 0.63 and κ = 0.62). The interobserver agreements of experienced endoscopists were good for both groups (κ = 0.75 and κ = 0.61, respectively).
Conclusions:
ME-OE showed better performance for detecting GIM than WLE in high-risk populations. (Clinical trial registration number: NCT04411589.).
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