title: A multicenter randomized comparison between high-definition white light endoscopy and narrow band imaging for detection of gastric lesions.
abstract: OBJECTIVE
  Narrow band imaging (NBI) is generally considered to be useful for lesion characterization, but not enhanced detection of gastric lesions, because of the dark endoscopic view. We tested whether the new generation of NBI (190-NBI or 290-NBI), which is twice as bright as the previous version, would improve detection of premalignant gastric lesions compared with high-definition white light endoscopy (HD-WLE).
  
  
  METHODS
  This was a multicenter prospective randomized study involving five tertiary institutions in the Asia-Pacific region. A total of 579 patients aged older than 50 years who underwent diagnostic upper gastrointestinal endoscopy were randomized to either HD-WLE or NBI. The outcome measurements were detection of intestinal metaplasia (IM), focal gastric lesions, and gastric cancers.
  
  
  RESULTS
  Focal gastric lesions were detected in 83/286 (29%) and 119/293 patients (40.6%) by HD-WLE and by NBI, respectively (P=0.003). IM was detected in 22/286 patients (7.7%) by HD-WLE and in 52/293 patients (17.7%) by NBI (P<0.001). Gastric cancer were found in 7/286 (2.4%) and 3/293 patients (1%) in HD-WLE and NBI groups, respectively (P=0.189).
  
  
  CONCLUSIONS
  NBI increased the detection rate of IM compared with HD-WLE.
authors.affiliation: aDepartment of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore bDivision of Gastroenterology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand cDepartment of Surgery, Chinese University of Hong Kong, Hong Kong, China dDepartment of Medicine, University of Malaya, Kuala Lumpur, Malaysia eDepartment of Gastroenterology, Lyell McEwin Hospital, Adelaide, Australia.
authors.forename: Tiing Leong
authors.initials: TL
authors.lastname: Ang
authors.forename: Rapat
authors.initials: R
authors.lastname: Pittayanon
authors.forename: James Yun Wong
authors.initials: JY
authors.lastname: Lau
authors.forename: Rungsun
authors.initials: R
authors.lastname: Rerknimitr
authors.forename: Shiaw Hooi
authors.initials: SH
authors.lastname: Ho
authors.forename: Rajvinder
authors.initials: R
authors.lastname: Singh
authors.forename: Andrew Boon Eu
authors.initials: AB
authors.lastname: Kwek
authors.forename: Daphne Shih Wen
authors.initials: DS
authors.lastname: Ang
authors.forename: Philip Wai Yan
authors.initials: PW
authors.lastname: Chiu
authors.forename: Sally
authors.initials: S
authors.lastname: Luk
authors.forename: Khean Lee
authors.initials: KL
authors.lastname: Goh
authors.forename: Jeannie Peng Lan
authors.initials: JP
authors.lastname: Ong
authors.forename: Jessica Yi-Lyn
authors.initials: JY
authors.lastname: Tan
authors.forename: Eng Kiong
authors.initials: EK
authors.lastname: Teo
authors.forename: Kwong Ming
authors.initials: KM
authors.lastname: Fock
mesh_terms: D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000175:diagnosis; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology