title: Assessment of still and moving images in the diagnosis of gastric lesions using magnifying narrow-band imaging in a prospective multicenter trial.
abstract: OBJECTIVE
  Magnifying narrow-band imaging (M-NBI) is more accurate than white-light imaging for diagnosing small gastric cancers. However, it is uncertain whether moving M-NBI images have additional effects in the diagnosis of gastric cancers compared with still images.
  
  
  METHODS
  A prospective multicenter cohort study.
  
  
  METHODS
  To identify the additional benefits of moving M-NBI images by comparing the diagnostic accuracy of still images only with that of both still and moving images. Still and moving M-NBI images of 40 gastric lesions were obtained by an expert endoscopist prior to this prospective multicenter cohort study. Thirty-four endoscopists from ten different Japanese institutions participated in the prospective multicenter cohort study. Each study participant was first tested using only still M-NBI images (still image test), then tested 1 month later using both still and moving M-NBI images (moving image test). The main outcome was a difference in the diagnostic accuracy of cancerous versus noncancerous lesions between the still image test and the moving image test.
  
  
  RESULTS
  Thirty-four endoscopists were analysed. There were no significant difference of cancerous versus noncancerous lesions between still and moving image tests in the diagnostic accuracy (59.9% versus 61.5%), sensitivity (53.4% versus 55.9%), and specificity (67.0% versus 67.6%). And there were no significant difference in the diagnostic accuracy between still and moving image tests of demarcation line (65.4% versus 65.5%), microvascular pattern (56.7% versus 56.9%), and microsurface pattern (48.1% versus 50.9%). Diagnostic accuracy showed no significant difference between the still and moving image tests in the subgroups of endoscopic findings of the lesions.
  
  
  CONCLUSIONS
  The addition of moving M-NBI images to still M-NBI images does not improve the diagnostic accuracy for gastric lesions. It is reasonable to concentrate on taking sharp still M-NBI images during endoscopic observation and use them for diagnosis.
  
  
  BACKGROUND
  Umin.ac.jp UMIN-CTR000008048.
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Doyama
authors.affiliation: Department of Gastroenterology, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Shirota
authors.affiliation: Department of Gastroenterology, Kanazawa Municipal Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan.
authors.forename: Youhei
authors.initials: Y
authors.lastname: Marukawa
authors.affiliation: Department of Gastroenterology, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Ohta
authors.affiliation: Department of Gastroenterology, Kanazawa Social Insurance Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Miwa
authors.affiliation: Department of Gastroenterology, Hokuriku Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Masunaga
authors.affiliation: Department of Gastroenterology, Kanazawa Red Cross Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Terasaki
authors.affiliation: Department of Gastroenterology, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matano
authors.affiliation: Department of Internal Medicine, Suzu General Hospital, Suzu, Ishikawa, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Department of Internal Medicine, Sangane Clinic, Kouta, Aichi, Japan.
authors.forename: Yoshibumi
authors.initials: Y
authors.lastname: Kaneko
authors.affiliation: Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Okada
authors.affiliation: Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurumaya
authors.affiliation: Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*