Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium
Objective: The advent and utility of new endoscopic imaging modalities for predicting the histology of Barrett’s esophagus (BE) in real time with high accuracy appear promising and could potentially obviate the need to perform random biopsies where guidelines are poorly adhered to. We embarked on ev...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2015-02-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377610 |
| _version_ | 1819083277943701504 |
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| author | Rajvinder Singh Mahesh Jayanna Jennie Wong Lee Guan Lim Jun Zhang Jing Lv Dong Liu Yi-Chia Lee Ming-Lun Han Ping-Huei Tseng Vikneswaran Namasivayam Rupa Banerjee Noriya Uedo Wah Kheong Chan Shiaw Hooi Ho Shi-yao Chen Shobna Bhatia Kohei Funasaka Takafumi Ando Justin Wu Cosmas Lesmana William Tam Wen-Lun Wang Chi-Yang Chang Hwoon-Yong Jung Kee Wook Jung Muhammad Begawan Bestari Kenshi Yao Vui Heng Chong Prateek Sharma Khek-Yu Ho |
| author_facet | Rajvinder Singh Mahesh Jayanna Jennie Wong Lee Guan Lim Jun Zhang Jing Lv Dong Liu Yi-Chia Lee Ming-Lun Han Ping-Huei Tseng Vikneswaran Namasivayam Rupa Banerjee Noriya Uedo Wah Kheong Chan Shiaw Hooi Ho Shi-yao Chen Shobna Bhatia Kohei Funasaka Takafumi Ando Justin Wu Cosmas Lesmana William Tam Wen-Lun Wang Chi-Yang Chang Hwoon-Yong Jung Kee Wook Jung Muhammad Begawan Bestari Kenshi Yao Vui Heng Chong Prateek Sharma Khek-Yu Ho |
| author_sort | Rajvinder Singh |
| collection | DOAJ |
| description | Objective: The advent and utility of new endoscopic imaging modalities for predicting the histology of Barrett’s esophagus (BE) in real time with high accuracy appear promising and could potentially obviate the need to perform random biopsies where guidelines are poorly adhered to. We embarked on evaluating the performance characteristics of white-light endoscopy with magnification (WLE-z), narrow-band imaging with magnification (NBI-z) and a combination of both modalities.
Design: This was a prospective online study with 28 endoscopists from 11 countries (Asia-Pacific region) participating as assessors. In total, 35 patients with BE were assessed using 150 slides from WLE-z and NBI-z randomly arranged using a simple classification with corresponding histology. The overall Accuracy (Acc), Sensitivity (Sn), Specificity (Sp), Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of WLE-z, NBI-z and a combination of both were calculated.
Results: The overall Acc for WLE-z and NBI-z images was 87.1 % and 88.7 %, respectively. When images from the two modalities were placed side by side, the Acc increased to 90.3 %. The Sn, Sp, PPV, and NPV of WLE-z were 48 %, 92 %, 45 %, and 93 % while with NBI-z, these improved to 89 %, 89 %, 56 %, and 98 %, respectively. When both imaging modalities were viewed together, they improved further to 93 %, 90 %, 61 %, and 99 %.
Conclusion: The high NPV (99 %) when both WLE-z and NBI-z were used simultaneously indicates that areas with regular appearance that are diagnosed with confidence can effectively be left alone and not biopsied when performed at a skilled resourced center. This approach could potentially lead to a paradigm shift of how patients with BE are assessed. |
| first_indexed | 2024-12-21T20:30:01Z |
| format | Article |
| id | doaj.art-f0e5959facd04d09bd223fdeb2a45b83 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-21T20:30:01Z |
| publishDate | 2015-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-f0e5959facd04d09bd223fdeb2a45b832022-12-21T18:51:15ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362015-02-010301E14E1810.1055/s-0034-1377610Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s ConsortiumRajvinder Singh0Mahesh Jayanna1Jennie Wong2Lee Guan Lim3Jun Zhang4Jing Lv5Dong Liu6Yi-Chia Lee7Ming-Lun Han8Ping-Huei Tseng9Vikneswaran Namasivayam10Rupa Banerjee11Noriya Uedo12Wah Kheong Chan13Shiaw Hooi Ho14Shi-yao Chen15Shobna Bhatia16Kohei Funasaka17Takafumi Ando18Justin Wu19Cosmas Lesmana20William Tam21Wen-Lun Wang22Chi-Yang Chang23Hwoon-Yong Jung24Kee Wook Jung25Muhammad Begawan Bestari26Kenshi Yao27Vui Heng Chong28Prateek Sharma29Khek-Yu Ho30Lyell McEwin Hospital, Adelaide, AustraliaLyell McEwin Hospital, Adelaide, AustraliaDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDivision of Gastroenterology, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, ChinaDivision of Gastroenterology, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, ChinaDivision of Gastroenterology, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Gastroenterology and Hepatology, Singapore General Hospital, SingaporeAsian Institute of Gastroenterology, Hyderabad, IndiaOsaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, JapanDivision of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, MalaysiaDivision of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, MalaysiaInstitute of Endoscopy, Zhongshan Hospital, Shanghai, ChinaDepartment of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, IndiaDepartment of Endoscopy, Nagoya University Hospital, Nagoya City, Aichi, JapanDepartment of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, JapanInstitute of Digestive Disease, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong KongDepartment of Internal Medicine and Gastroenterology, Cipto Mangunkusumo Hospital, Jakarta, IndonesiaLyell McEwin Hospital, Adelaide, AustraliaDepartment of Internal Medicine, E-Da Hospital/I-Shou University, Kaohshiung, TaiwanDepartment of Internal Medicine, E-Da Hospital/I-Shou University, Kaohshiung, TaiwanDepartment of Gastroenterology, Asan Medical Center, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, Seoul, KoreaDepartment of Internal Medicine, Padjadjaran University, Bandung, IndonesiaDepartment of Gastroenterology, Fukuoka University, Chikushi Hospital, Fukuoka, JapanDepartment of Gastroenterology, RIPAS Hospital, Brunei DarussalamDivision of Gastroenterology and Hepatology, Veterans Affairs Medical Centre and University of Kansas School of Medicine, Kansas City, MO, United StatesDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeObjective: The advent and utility of new endoscopic imaging modalities for predicting the histology of Barrett’s esophagus (BE) in real time with high accuracy appear promising and could potentially obviate the need to perform random biopsies where guidelines are poorly adhered to. We embarked on evaluating the performance characteristics of white-light endoscopy with magnification (WLE-z), narrow-band imaging with magnification (NBI-z) and a combination of both modalities. Design: This was a prospective online study with 28 endoscopists from 11 countries (Asia-Pacific region) participating as assessors. In total, 35 patients with BE were assessed using 150 slides from WLE-z and NBI-z randomly arranged using a simple classification with corresponding histology. The overall Accuracy (Acc), Sensitivity (Sn), Specificity (Sp), Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of WLE-z, NBI-z and a combination of both were calculated. Results: The overall Acc for WLE-z and NBI-z images was 87.1 % and 88.7 %, respectively. When images from the two modalities were placed side by side, the Acc increased to 90.3 %. The Sn, Sp, PPV, and NPV of WLE-z were 48 %, 92 %, 45 %, and 93 % while with NBI-z, these improved to 89 %, 89 %, 56 %, and 98 %, respectively. When both imaging modalities were viewed together, they improved further to 93 %, 90 %, 61 %, and 99 %. Conclusion: The high NPV (99 %) when both WLE-z and NBI-z were used simultaneously indicates that areas with regular appearance that are diagnosed with confidence can effectively be left alone and not biopsied when performed at a skilled resourced center. This approach could potentially lead to a paradigm shift of how patients with BE are assessed.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377610 |
| spellingShingle | Rajvinder Singh Mahesh Jayanna Jennie Wong Lee Guan Lim Jun Zhang Jing Lv Dong Liu Yi-Chia Lee Ming-Lun Han Ping-Huei Tseng Vikneswaran Namasivayam Rupa Banerjee Noriya Uedo Wah Kheong Chan Shiaw Hooi Ho Shi-yao Chen Shobna Bhatia Kohei Funasaka Takafumi Ando Justin Wu Cosmas Lesmana William Tam Wen-Lun Wang Chi-Yang Chang Hwoon-Yong Jung Kee Wook Jung Muhammad Begawan Bestari Kenshi Yao Vui Heng Chong Prateek Sharma Khek-Yu Ho Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium Endoscopy International Open |
| title | Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium |
| title_full | Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium |
| title_fullStr | Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium |
| title_full_unstemmed | Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium |
| title_short | Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium |
| title_sort | narrow band imaging and white light endoscopy with optical magnification in the diagnosis of dysplasia in barrett s esophagus results of the asia pacific barrett s consortium |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1377610 |
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