Japan Digestive Disease Week 2016
International Poster Session(JDDW)
November 4 (Fri.), 9:30–10:10, Room 16 (Kobe International Exhibition Hall No. 2 Building Hall (North) Digital Poster Session)
IP-1_E
Comparison of white light endoscopy, NBI and confocal endomicroscopy for the real time diagnosis of Barrett's oesophagus
- 1
- NUH
Background
White light endoscopy (WLE) is the gold standard tool for Barrett's oesophagus. Additional tools exist such as NBI and confocal endomicroscopy (CE). This study aimed to compare all three modalities for the real time diagnosis and decision making of columnar lined oesophagus (CLO).
Methods
56 patients were prospectively enrolled in the study. Endoscopic assessment for CLO occurred using WLE, NBI and CE. Diagnostic certainty (rated < low 50 %, medium 50-90 % and high > 90 %), need to biopsy and time to obtain a diagnosis were recorded.
Results
The mean age of the patients was 58.9 years (range 30-86) and 57 % were male. Sensitivity/ Specificity for WLE was 82.4/62.5 %, NBI 82.4/70 %, CE 62.5/60 %. PPV WLE 24.6 %, NBI 24.6 %, CE 27.8 %. NPV WLE 43.9 %, NBI 49.1 %, CE 33.3 %. AUC WLE 0.76, NBI 0.79, CE 0.45. Diagnostic certainty was medium across the board (WLE 76.5%, NBI 86.7 %, CE 66.7 %). The need to biopsy for WLE was 82.4 %, NBI 81.3 % and CE 89 %. Time for diagnosis for WLE was 36.1 s, NBI 35 s, CE 102 s.
Discussion and Conclusion
NBI may prove to be the most ideal platform for the real time diagnosis of CLO. However there is still diagnostic uncertainty and a need to biopsy for all modalities.
White light endoscopy (WLE) is the gold standard tool for Barrett's oesophagus. Additional tools exist such as NBI and confocal endomicroscopy (CE). This study aimed to compare all three modalities for the real time diagnosis and decision making of columnar lined oesophagus (CLO).
Methods
56 patients were prospectively enrolled in the study. Endoscopic assessment for CLO occurred using WLE, NBI and CE. Diagnostic certainty (rated < low 50 %, medium 50-90 % and high > 90 %), need to biopsy and time to obtain a diagnosis were recorded.
Results
The mean age of the patients was 58.9 years (range 30-86) and 57 % were male. Sensitivity/ Specificity for WLE was 82.4/62.5 %, NBI 82.4/70 %, CE 62.5/60 %. PPV WLE 24.6 %, NBI 24.6 %, CE 27.8 %. NPV WLE 43.9 %, NBI 49.1 %, CE 33.3 %. AUC WLE 0.76, NBI 0.79, CE 0.45. Diagnostic certainty was medium across the board (WLE 76.5%, NBI 86.7 %, CE 66.7 %). The need to biopsy for WLE was 82.4 %, NBI 81.3 % and CE 89 %. Time for diagnosis for WLE was 36.1 s, NBI 35 s, CE 102 s.
Discussion and Conclusion
NBI may prove to be the most ideal platform for the real time diagnosis of CLO. However there is still diagnostic uncertainty and a need to biopsy for all modalities.
- Index Term 1: Barrett's oesophagus
- Index Term 2: Real time decision making