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Endoscopy 2010; 42(5): 351-359
DOI: 10.1055/s-0029-1243949
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis

J.  Mannath1 [*] , V.  Subramanian1 [*] , C.  J.  Hawkey1 , K.  Ragunath1
  • 1Nottingham Digestive Diseases Centre, NIHR Biomedical Research Unit, Queens Medical Centre Campus, University of Nottingham, UK
Further Information

Publication History

submitted 08 September 2009

accepted after revision 2 December 2009

Publication Date:
03 March 2010 (online)

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Commentaire de travail de J. Mannath et al., pp. 351Endoscopy 2010; 42(05): 433-433
DOI: 10.1055/s-0031-1291852

Background and study aim: Narrow band imaging (NBI), a novel endoscopic technique that highlights mucosal surface structures and microvasculature is increasingly advocated as a tool to detect and characterize neoplasia and intestinal metaplasia in patients with Barrett’s esophagus. We aimed to assess the diagnostic accuracy of NBI with magnification for the diagnosis of high grade dysplasia (HGD) and specialized intestinal metaplasia (SIM) in patients with Barrett’s esophagus.

Methods: We performed a meta-analysis of studies which compared NBI-based diagnosis of HGD and SIM with histopathology as the gold standard.

Results: Eight studies including 446 patients with 2194 lesions met the inclusion criteria. For diagnosing HGD, the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.96 (95 % confidence interval [CI] 0.93 – 0.99), 0.94 (95 %CI 0.84 – 1.0), 342.49 (95 %CI 40.49 – 2896.89) and 0.99 (SE 0.01) on a per-lesion analysis with similar results on per-patient analysis.. For the characterization of SIM, the pooled sensitivity, specificity, DOR, and AUC were 0.95 (95 %CI 0.87 – 1.0), 0.65 (95 %CI 0.52 – 0.78), 37.53 (95 %CI 6.50 – 217.62) and 0.88 (SE 0.08) on a per-lesion analysis.

Conclusion: NBI with magnification is accurate with high diagnostic precision for diagnosis of HGD in Barrett’s esophagus on the basis of irregular mucosal pit patterns and/or irregular microvasculature. NBI has high sensitivity but poor specificity for characterizing SIM.

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1 J. M. and V. S. are joint first authors

K. RagunathMD 

Nottingham Digestive Diseases Centre,
NIHR Biomedical Research Unit
Queens Medical Centre Campus
Nottingham University Hospitals NHS Trust

Nottingham NG7 2UH
UK

Fax: +44-115-9422232

Email: K.Ragunath@nottingham.ac.uk