title: Trimodal imaging endoscopy may improve diagnostic accuracy of early gastric neoplasia: a feasibility study.
abstract: BACKGROUND
  A considerable number of superficial gastric neoplasias are overlooked with conventional white light imaging (WLI) endoscopy.
  
  
  OBJECTIVE
  The aim was to investigate the diagnostic potential of trimodal imaging endoscopy (TME), which combines WLI, autofluorescence imaging (AFI), and narrow-band imaging (NBI), for superficial gastric neoplasia.
  
  
  METHODS
  Feasibility study.
  
  
  METHODS
  Single academic center.
  
  
  METHODS
  Sixty-two patients with or without gastric neoplasia.
  
  
  METHODS
  Each patient serially assessed with WLI, AFI, and magnifying endoscopy with NBI (ME-NBI) by an endoscopist blinded for clinical information. ME-NBI over WLI and AFI was designated as TME. Histopathology of biopsy and ESD specimens was evaluated and used as the gold standard.
  
  
  METHODS
  Sensitivity and specificity of endoscopic diagnosis of pathology-proven neoplasia by per-patient and per-lesion analyses.
  
  
  RESULTS
  The study included 47 pathology-proven neoplasias and 44 pathology-proven nonneoplasias that were detected as neoplasias with any of the modalities. By a per-lesion analysis, the sensitivity of TME (89.4%) was higher than that of WLI (76.6%) and AFI (68.1%). The specificity of TME (98.0%) was higher than that of WLI (84.3%) and AFI (23.5%). By a per-patient analysis, the sensitivity of TME (90.9%) was higher than that of WLI (75%) and AFI (68.2%). The specificity of TME (100%) was higher than that of WLI (72.2%) and AFI (44.4%).
  
  
  CONCLUSIONS
  Case-enriched population at a single center.
  
  
  CONCLUSIONS
  Higher diagnostic accuracy of TME over conventional WLI indicates the feasibility of TME for the efficacious diagnosis of early gastric neoplasia.
authors: Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan. masa-kato@jikei.ac.jp
authors: Masayuki
authors: M
authors: Kato
authors: Mitsuru
authors: M
authors: Kaise
authors: Jin
authors: J
authors: Yonezawa
authors: Kenichi
authors: K
authors: Goda
authors: Hirobumi
authors: H
authors: Toyoizumi
authors: Noboru
authors: N
authors: Yoshimura
authors: Yukinaga
authors: Y
authors: Yoshida
authors: Muneo
authors: M
authors: Kawamura
authors: Hisao
authors: H
authors: Tajiri
mesh_terms: D003937:Diagnosis, Differential; D004210:Dissection / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*