Blue-light imaging has an additional value to white-light endoscopy in visualization of early Barrett's neoplasia: an international multicenter cohort study.
Journal
Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
08
08
2018
accepted:
24
10
2018
pubmed:
13
11
2018
medline:
17
9
2019
entrez:
13
11
2018
Statut:
ppublish
Résumé
Endoscopic features of early neoplasia in Barrett's esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett's neoplasia. Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores). Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01). BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone. (ISRCTN registry study ID: ISRCTN15916689.).
Sections du résumé
BACKGROUND AND AIMS
Endoscopic features of early neoplasia in Barrett's esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett's neoplasia.
METHODS
Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores).
RESULTS
Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01).
CONCLUSIONS
BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone. (ISRCTN registry study ID: ISRCTN15916689.).
Identifiants
pubmed: 30419218
pii: S0016-5107(18)33259-0
doi: 10.1016/j.gie.2018.10.046
pii:
doi:
Banques de données
ISRCTN
['ISRCTN15916689']
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
749-758Informations de copyright
Copyright © 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.