Background and Aims

Endoscopic features of early neoplasia in Barrett's esophagus (BE) are subtle. Blue-light imaging (BLI) may improve visualization of neoplastic lesions. The aim of this study was to evaluate BLI in visualization of Barrett’s neoplasia.

Methods

Corresponding white-light endoscopy (WLE) and BLI images of 40 BE lesions were obtained prospectively and assessed by 6 international experts in 3 assessments. Each assessment consisted of overview and magnification images. Assessments were as follows: assessment 1, WLE only; assessment 2, BLI only; and assessment 3, corresponding WLE and BLI images. Outcome parameters were as follows: (1) appreciation of macroscopic appearance and surface relief (visual analog scale scores); (2) ability to delineate lesions (visual analog scale scores); (3) preferred technique for delineation (ordinal scores); and (4) quantitative agreement on delineations (AND/OR scores).

Results

Experts appreciated BLI significantly better than WLE for visualization of macroscopic appearance (median 8.0 vs 7.0, P < .001) and surface relief (8.0 vs 6.0, P < .001). For both overview and magnification images, experts appreciated BLI significantly better than WLE for ability to delineate lesions (8.0 vs 6.0, P < .001 and 8.0 vs 5.0, P < .001). There was no overall significant difference in AND/OR scores of WLE + BLI when compared with WLE, yet agreement increased significantly with WLE + BLI for cases with a low baseline AND/OR score on WLE, both in overview (mean difference, 0.15; P = .015) and magnification (mean difference, 0.10; P = .01).

Conclusions

BLI has additional value for visualization of BE neoplasia. Experts appreciated BLI better than WLE for visualization and delineation of BE neoplasia. Quantitative agreement increased significantly when BLI was offered next to WLE for lesions that were hard to delineate with WLE alone. (ISRCTN registry study ID: ISRCTN15916689.)

中文翻译：

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在早期Barrett瘤形成的可视化中，蓝光成像对白光内窥镜检查具有额外的价值：一项国际多中心队列研究

背景和目标

巴雷特食管（BE）的早期赘生物的内窥镜特征微妙。蓝光成像（BLI）可以改善肿瘤病变的可视化。这项研究的目的是评估BLI在巴雷特瘤形成的可视化中的作用。

方法

前瞻性获得了40个BE病变的相应白光内窥镜（WLE）和BLI图像，并由6名国际专家在3个评估中进行了评估。每个评估都包括概图和放大图像。评估如下：评估1，仅限WLE；评估1，仅适用于WLE。评估2，仅BLI；和评估3，相应的WLE和BLI图像。结果参数如下：（1）对宏观外观和表面起伏的欣赏（视觉模拟量表分数）；（2）划定病变的能力（视觉模拟量表分数）；（3）描绘的首选技术（普通分数）；（4）关于划定（与/或分数）的定量协议。

结果

专家赞赏BLI在宏观外观（中位数8.0 vs 7.0，P  <.001）和表面起伏（8.0 vs 6.0，P  <.001）方面明显优于WLE 。对于概览图像和放大图像，专家们对病变的描绘能力明显优于WLE（8.0 vs 6.0，P  <.001和8.0 vs 5.0，P  <.001）。与WLE相比，WLE + BLI的AND / OR得分没有总体上的显着差异，但在WLE基线AND / OR得分较低的情况下，WLE + BLI的一致性显着提高（均值，0.15；P  = .015）和放大倍率（均值差，0.10；P  = .01）。

结论

BLI对于可视化BE瘤形成具有附加价值。专家对BE瘤的可视化和轮廓分明，BLI比WLE更好。对于难以用WLE单独描述的病变，在WLE旁提供BLI时，定量一致性显着提高。（ISRCTN注册研究ID：ISRCTN15916689。）