title: Magnifying narrow-band imaging versus magnifying white-light imaging for the differential diagnosis of gastric small depressive lesions: a prospective study.
abstract: BACKGROUND
  The accurate diagnosis of gastric small depressive lesions (SDLs), including gastritis and cancerous lesions, is difficult with conventional endoscopy when using white-light imaging (WLI). Narrow-band imaging (NBI) is expected to make a more accurate diagnosis of gastric SDLs than WLI because it provides better visualization of the mucosal surface and microvascular architecture when combined with magnifying endoscopy.
  
  
  OBJECTIVE
  To compare the real-time diagnostic accuracy of magnifying WLI and magnifying NBI for gastric SDLs.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  National Cancer Center Hospital East, Kashiwa, Japan.
  
  
  METHODS
  Fifty-seven lesions in 53 consecutive patients were analyzed: 30 cancers and 27 benign lesions.
  
  
  METHODS
  If previously undiagnosed gastric SDLs smaller than 10 mm were identified during an endoscopic examination, magnifying observation with both WLI and NBI was performed for each SDL. Endoscopic diagnosis of SDLs was made by each method on site.
  
  
  METHODS
  The diagnostic accuracy and the time required for diagnosis.
  
  
  RESULTS
  The diagnostic accuracy was significantly higher for NBI than for WLI (79% vs 44%; P = .0001), as was its sensitivity (70% vs 33%; P = .0005). The diagnostic specificity of NBI (89%) was higher than that of WLI (67%), but the difference was not statistically significant. The time required for the diagnosis was equivalent with both methods.
  
  
  CONCLUSIONS
  Single-center study, small sample size.
  
  
  CONCLUSIONS
  Adding NBI to the WLI examination is essential for making an accurate diagnosis of gastric SDLs compared with magnifying WLI alone. (UMIN Clinical Trials Registry identification number C000000421).
authors.affiliation: Department of Multidisciplinary Cancer Treatment, Graduate School of Medicine, Kyoto University, Kyoto, Japan. yasuzoe@kuhp.kyoto-u.ac.jp
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Ezoe
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Horimatsu
authors.forename: Keiko
authors.initials: K
authors.lastname: Minashi
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sano
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
mesh_terms: D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005756:Gastritis / Q000175:diagnosis*; D006801:Humans; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology