Correlation between narrow band imaging and nonneoplastic gastric pathology: a pilot feasibility trial

Gastrointest Endosc. 2008 Feb;67(2):210-6. doi: 10.1016/j.gie.2007.06.009.


Background: A novel narrow band imaging (NBI) system is able to visualize the mucosal and vascular network in the GI tract.

Objective: The aim of the current study was to test the feasibility of NBI to predict gastric histologic diagnosis.

Design: A pilot feasibility study.

Setting: Veterans Affairs Medical Center.

Patients: Forty-seven patients undergoing upper endoscopy for various indications were prospectively enrolled.

Methods: The gastric body and antrum were systematically examined by NBI before targeted biopsies. Images were graded according to the mucosal (ridge/villous and circular) and vascular patterns and correlated with histologic findings in a blinded manner.

Main outcome measurements: Final histologic diagnosis based on updated Sydney classification system.

Results: Overall, 25 patients (53.1%) had a normal biopsy specimen, 13 (27.6%) had non-Helicobacter pylori gastritis, 4 (8.5%) had H pylori gastritis, and 5 (10.6%) had intestinal metaplasia. The sensitivity, specificity, and positive predictive value of a regular mucosal and vascular pattern for the diagnosis of normal mucosa/mild gastritis were 89%, 78%, and 94%, respectively. The sensitivity and specificity of an irregular pattern with decreased density of vessels for the diagnosis of H pylori were 75% and 88%, and that of the ridge/villous pattern for the diagnosis of intestinal metaplasia were 80% and 100%, respectively.

Limitation: The small number of patients with H pylori and intestinal metaplasia was the main limitation.

Conclusions: This is the first U.S. study of NBI for gastric lesions. NBI may help predict in vivo histologic diagnosis of gastric pathologic conditions with a good degree of accuracy. Future larger studies are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal / methods*
  • Feasibility Studies
  • Female
  • Gastric Mucosa / blood supply
  • Gastric Mucosa / pathology*
  • Gastritis / microbiology
  • Gastritis / pathology
  • Helicobacter Infections / pathology
  • Helicobacter pylori
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Sensitivity and Specificity
  • Stomach Diseases / diagnosis*