Is it proper to use non-magnified narrow-band imaging for esophageal neoplasia screening? Japanese single-center, prospective study.
OBJECTIVE
Most screening examinations in Japanese general hospitals are carried out by high-definition television-incompatible (non-HD) scopes and non-magnifying endoscopes. We evaluated the narrow-band imaging (NBI) real-time diagnostic yield of esophageal neoplasia in high-risk patients at a general hospital.


METHODS
In a single-center, prospective, non-randomized controlled trial, 117 consecutive screening patients with high risk for esophageal cancer received primary white-light imaging (WLI) followed by NBI and iodine-staining endoscopy (59 by HDTV-compatible [HD] endoscopy and 58 by non-HD endoscopy). The primary aim was to evaluate the diagnostic yield of non-magnified images in diagnosing esophageal neoplasia. The secondary aim was to compare HD endoscopy and non-HD endoscopy in terms of diagnostic performance.


RESULTS
Overall, the sensitivity of NBI for screening of esophageal neoplasia was superior to WLI, and equivalent to iodine staining (92% vs 42%; P < 0.05, 92% vs 100%; ns). The specificity of NBI was equivalent to WLI (89% vs 94%; ns). In HD, NBI sensitivity was equivalent to both iodine staining and WLI (100% vs 75%; ns). In non-HD, NBI sensitivity was equivalent to iodine staining, but WLI sensitivity was significantly inferior to NBI (88% vs 100%; ns, 25% vs 88%; P < 0.05). The NBI specificity was equivalent to WLI not only in HD but also in non-HD (90% vs 96%; ns, 88% vs 93%; ns).


CONCLUSIONS
In both HD and non-HD endoscopy, NBI is less likely than WLI to miss a lesion. Even with non-HD endoscopy, NBI is suitable for esophageal standard examinations in general hospitals.
Department of Gastroenterology, International Goodwill Hospital, Yokohama, Japan. yokoaki0821@yahoo.co.jp
Akira
A
Yokoyama
Katsuro
K
Ichimasa
Tomonari
T
Ishiguro
Yuichi
Y
Mori
Haruo
H
Ikeda
Takemasa
T
Hayashi
Hitomi
H
Minami
Seiko
S
Hayashi
Gen
G
Watanabe
Haruhiro
H
Inoue
Shin-ei
SE
Kudo
D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors