Aims:
Endoscopic surveillance is mainstream to diagnose BE and its complications. BLI/LCI of ELUXEO system (Fujifilm, Tokyo, Japan) has emerged as powerful image enhancement diagnostic tool for neoplastic lesions. The aim of our study was to evaluate the performance of this system to characterize BE and its complications.
Methods:
We conducted a 6-month prospective study in 2 university hospitals. Patients with known BE were included. A thorough analysis was done by an expert endoscopist during gastroscopy: 1 or 2 areas of interest (AoI) were selected in every patient then studied in white light, BLI and LCI and photos were taken in every modality at 3 zoom levels. Mucosal pattern (villous, circular or tubular glands; absent or enlarged glands) and vascular pattern (regular vessels; enlarged, tortuous or absent vessels) were evaluated. Each AoI was biopsied separately.
Results:
25 patients were included (median age 65 +/- 9.5 years, 68% males) and 31 AoI were analyzed. Histology showed that 21 (67.7%) AoI were nondysplastic BE (NDBE), 8 (25.8%) were High-grade dysplasia (HGD) or adenocarcinoma (ADC) and 2 were gastric metaplasia.
Prediction of histology was 91.3% for NDBE and 100% for HGD/ADC. Regarding mucosal pattern, NDBE showed 100% regular glands with 71.4% circular pattern. For HGD/ADC analysis, the sensitivity for enlarged glands and absence of glands was respectively 50% and 70%, with 100% specificity, leading to a NPV of 83% and 91% and a PPV of 100%. Concerning vascular pattern, the vessels were regular in 100% of NDBE. For HDG/ADC the sensitivity for enlarged vessels, tortuous vessels and absence of vessels was respectively 100%, 87.5% and 37.5%, corresponding to a NPV of 100%, 95.2% and 80%.
Conclusions:
In this preliminary study, ELUXEO associated to BLI/LCI has high sensitivity to detect NDBE and high specificity for HGD/ADC. Further prospective large scale trials are needed to validate our findings.
