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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(02): 106-111
DOI: 10.1055/s-0040-1713553
Review Article

Interpretation of Benign Gastric Mucosal Lesions Using Narrow-Band Imaging

Sameer Paghadhar
1   Department of Gastroenterology, Gleneagles Global Health City, Chennai, Tamil Nadu, India
,
Mayank Jain
2   Department of Gastroenterology, Arihant Hospital and Research Centre, Indore, Madhya Pradesh, India
,
B. Mahadevan
1   Department of Gastroenterology, Gleneagles Global Health City, Chennai, Tamil Nadu, India
,
Jayanthi Venkataraman
3   Department of Gastroenterology, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
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Abstract

The major drawback of conventional white light endoscopy (WLE) is that it lacks accuracy in diagnosis and differentiation of various benign and premalignant mucosal gastrointestinal lesions. To overcome this, image-enhanced endoscopy techniques, which provide high-definition images with good resolution and contrast enhancement, have been developed. One such technique is narrow-band imaging (NBI). NBI functions by filtering the illumination light. The red component of the standard red, green, and blue filters is rejected and the selected bandwidth of the blue and green light is transmitted. The present review highlights the role of NBI in diagnosis of benign gastric lesions like atrophic gastritis, Helicobacter pylori–related gastritis, intestinal metaplasia, and other rarer conditions. NBI is a simple procedure which does not require any additional equipment and does not have a long learning curve. Use of NBI in daily practice is likely to improve detection of mucosal abnormalities.

Keywords

endoscopy - gastric - imaging - mucosa


Publication History

Article published online:
03 July 2020

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  • References

  • 1 Ezoe Y, Muto M, Horimatsu T. et al. Magnifying narrow-band imaging versus magnifying white-light imaging for the differential diagnosis of gastric small depressive lesions: a prospective study. Gastrointest Endosc 2010; 71 (03) 477-484
    CrossrefPubMedGoogle Scholar
  • 2 Sano Y. New diagnostic method based on color imaging using narrow-band imaging (NBI) system for gastrointestinal tract. Gastrointest Endosc 2001; 53: 125
    CrossrefPubMedGoogle Scholar
  • 3 Gono K, Obi T, Yamaguchi M. et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 2004; 9 (03) 568-577
    CrossrefPubMedGoogle Scholar
  • 4 Yao K, Oishi T. Microgastroscopic findings of mucosal microvascular architecture as visualized by magnifying endoscopy. Dig Endosc 2001; 13 (Suppl. 01) S27-S33
    CrossrefGoogle Scholar
  • 5 Microanatomies as visualized using magnifying endoscopy with narrow band imaging in the stomach: which microanatomical structures can we visualize in the glandular epithelium using narrow band imaging, and how is this achieved?. In: Yao K. ed. Zoom Gastroscopy: Magnifying Endoscopy in the Stomach. Tokyo, Japan: Springer; 2013: 57-69
    Google Scholar
  • 6 Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy 2009; 41 (05) 462-467
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Yao K. Clinical applications of magnifying endoscopy with narrow-band imaging (M-NBI) of the stomach. In: Yao K. ed. Zoom Gastroscopy: Magnifying Endoscopy in the Stomach. Tokyo, Japan: Springer; 2013: 83-87
    Google Scholar
  • 8 Yagi K, Nakamura A, Sekine A. Characteristic endoscopic and magnified endoscopic findings in the normal stomach without Helicobacter pylori infection. J Gastroenterol Hepatol 2002; 17 (01) 39-45
    CrossrefPubMedGoogle Scholar
  • 9 Yao K. Gastric microvascular architecture as visualized by magnifying endoscopy: body and antral mucosa without pathologic change demonstrate two different patterns of microvascular architecture. Gastrointest Endosc 2004; 59 (04) 596-597, author reply 597
    PubMedGoogle Scholar
  • 10 Bansal A, Ulusarac O, Mathur S, Sharma P. Correlation between narrow band imaging and nonneoplastic gastric pathology: a pilot feasibility trial. Gastrointest Endosc 2008; 67 (02) 210-216
    CrossrefPubMedGoogle Scholar
  • 11 Eshmuratov A, Nah JC, Kim N. et al. The correlation of endoscopic and histological diagnosis of gastric atrophy. Dig Dis Sci 2010; 55 (05) 1364-1375
    CrossrefPubMedGoogle Scholar
  • 12 Banerjee R, Reddy N. A Primer on Narrow Band Imaging. India: Paras Publishing, 2009
  • 13 Anagnostopoulos GK, Yao K, Kaye P. et al. High-resolution magnification endoscopy can reliably identify normal gastric mucosa, Helicobacter pylori-associated gastritis, and gastric atrophy. Endoscopy 2007; 39 (03) 202-207
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Sauerbruch T, Schreiber MA, Schüssler P, Permanetter W. Endoscopy in the diagnosis of gastritis. Diagnostic value of endoscopic criteria in relation to histological diagnosis. Endoscopy 1984; 16 (03) 101-104
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Redéen S, Petersson F, Jönsson KA, Borch K. Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample. Endoscopy 2003; 35 (11) 946-950
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Lin BR, Shun CT, Wang TH, Lin JT. Endoscopic diagnosis of intestinal metaplasia of stomach - accuracy judged by histology. Hepatogastroenterology 1999; 46 (25) 162-166
    PubMedGoogle Scholar
  • 17 Meshkinpour H, Orlando RA, Arguello JF, DeMicco MP. Significance of endoscopically visible blood vessels as an index of atrophic gastritis. Am J Gastroenterol 1979; 71 (04) 376-379
    PubMedGoogle Scholar
  • 18 Nagata N, Shimbo T, Akiyama J. et al. Predictability of gastric intestinal metaplasia by mottled patchy erythema seen on endoscopy. Gastroenterol Res 2011; 4 (05) 203-209
    PubMedGoogle Scholar
  • 19 Kaminishi M, Yamaguchi H, Nomura S. et al. Endoscopic classification of chronic gastritis based on a pilot study by the Research Society for Gastritis. Dig Endosc 2002; 14: 138-151
    CrossrefGoogle Scholar
  • 20 Kikuste I, Marques-Pereira R, Monteiro-Soares M. et al. Systematic review of the diagnosis of gastric premalignant conditions and neoplasia with high-resolution endoscopic technologies. Scand J Gastroenterol 2013; 48 (10) 1108-1117
    CrossrefPubMedGoogle Scholar
  • 21 Uedo N, Ishihara R, Iishi H. et al. A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy. Endoscopy 2006; 38 (08) 819-824
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Buxbaum JL, Hormozdi D, Dinis-Ribeiro M. et al. Narrow-band imaging versus white light versus mapping biopsy for gastric intestinal metaplasia: a prospective blinded trial. Gastrointest Endosc 2017; 86 (05) 857-865
    CrossrefPubMedGoogle Scholar
  • 23 Savarino E, Corbo M, Dulbecco P. et al. Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia. World J Gastroenterol 2013; 19 (17) 2668-2675
    CrossrefPubMedGoogle Scholar
  • 24 Dutta AK, Sajith KG, Pulimood AB, Chacko A. Narrow band imaging versus white light gastroscopy in detecting potentially premalignant gastric lesions: a randomized prospective crossover study. Indian J Gastroenterol 2013; 32 (01) 37-42
    CrossrefPubMedGoogle Scholar
  • 25 Pimentel-Nunes P, Dinis-Ribeiro M, Soares JB. et al. A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions. Endoscopy 2012; 44 (03) 236-246
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Yao K, Iwashita A, Tanabe H. et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc 2008; 68 (03) 574-580
    CrossrefPubMedGoogle Scholar
  • 27 Yao K, Iwashita A, Nambu M. et al. Nature of white opaque substance in gastric epithelial neoplasia as visualized by magnifying endoscopy with narrow-band imaging. Dig Endosc 2012; 24 (06) 419-425
    CrossrefPubMedGoogle Scholar
  • 28 Ueo T, Yonemasu H, Yada N. et al. White opaque substance represents an intracytoplasmic accumulation of lipid droplets: immunohistochemical and immunoelectron microscopic investigation of 26 cases. Dig Endosc 2013; 25 (02) 147-155
    CrossrefPubMedGoogle Scholar
  • 29 Yamasaki Y, Uedo N, Kanzaki H. et al. Investigation of mucosal pattern of gastric antrum using magnifying narrow-band imaging in patients with chronic atrophic fundic gastritis. Ann Gastroenterol 2017; 30 (03) 302-308
    Google Scholar
  • 30 Yagi K, Nakamura A, Sekine A. Characteristic endoscopic and magnified endoscopic findings in the normal stomach without helicobacter pylori infection. J Gastroenterol Hepatol 2002; 17 (01) 39-45
    CrossrefPubMedGoogle Scholar
  • 31 Yagi K, Nakamura A, Sekine A. Comparison between magnifying endoscopy and histological, culture and urease test findings from the gastric mucosa of the corpus. Endoscopy 2002; 34 (05) 376-381
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Nakagawa S, Kato M, Shimizu Y. et al. Relationship between histopathologic gastritis and mucosal microvascularity: observations with magnifying endoscopy. Gastrointest Endosc 2003; 58 (01) 71-75
    CrossrefPubMedGoogle Scholar
  • 33 Tahara T, Shibata T, Nakamura M. et al. Gastric mucosal pattern by using magnifying narrow-band imaging endoscopy clearly distinguishes histological and serological severity of chronic gastritis. Gastrointest Endosc 2009; 70 (02) 246-253
    CrossrefPubMedGoogle Scholar
  • 34 Banerjee R, Ramji C, Mansard MJ. et al. High resolution narrow band imaging (NBI) can identify normal gastric mucosa andH. pylori (HP) associated gastritis. Gastrointest Endosc 2007; 65: AB178
    Google Scholar
  • 35 Yagi K, Saka A, Nozawa Y, Nakamura A. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer. Helicobacter 2014; 19 (02) 111-115
    CrossrefPubMedGoogle Scholar
  • 36 Okubo M, Tahara T, Shibata T. et al. Changes in gastric mucosal patterns seen by magnifying NBI during H. pylori eradication. J Gastroenterol 2011; 46 (02) 175-182
    CrossrefPubMedGoogle Scholar
  • 37 Castro R, Pimentel-Nunes P, Dinis-Ribeiro M. Evaluation and management of gastric epithelial polyps. Best Pract Res Clin Gastroenterol 2017; 31 (04) 381-387
    CrossrefPubMedGoogle Scholar
  • 38 Omori T, Kamiya Y, Tahara T. et al. Correlation between magnifying narrow band imaging and histopathology in gastric protruding/or polypoid lesions: a pilot feasibility trial. BMC Gastroenterol 2012; 12 (01) 17
    CrossrefPubMedGoogle Scholar
  • 39 Ripoll C, Garcia-Tsao G. Management of gastropathy and gastric vascular ectasia in portal hypertension. Clin Liver Dis 2010; 14 (02) 281-295
    CrossrefPubMedGoogle Scholar
  • 40 Kamath PS, Shah VH. Portal hypertension and bleeding esophageal varices. In: Boyer TD, Manns MP, Sanyal AJ. eds. Zakim and Boyer’s Hepatology: A Textbook of Liver Disease. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012: 296-326
    Google Scholar
  • 41 Feldman M, Lee EL. Gastritis. In: Feldman M, Friedman LS, Brandt LJ. eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed.. Philadelphia, PA: Elsevier Saunders; 2010: 868-883
    Google Scholar
  • 42 Vigneri S, Termini R, Piraino A, Scialabba A, Pisciotta G, Fontana N. The stomach in liver cirrhosis. Endoscopic, morphological, and clinical correlations. Gastroenterology 1991; 101 (02) 472-478
    CrossrefPubMedGoogle Scholar
  • 43 Hayashi S, Saeki S. Endoscopic microvascular architecture of the portal hypertensive gastric mucosa on narrow band imaging. Dig Endosc 2007; 19: 116-123
    CrossrefGoogle Scholar
  • 44 Patwardhan VR, Cardenas A. Review article: the management of portal hypertensive gastropathy and gastric antral vascular ectasia in cirrhosis. Aliment Pharmacol Ther 2014; 40 (04) 354-362
    CrossrefPubMedGoogle Scholar
  • 45 Kamath PS, Lacerda M, Ahlquist DA, McKusick MA, Andrews JC, Nagorney DA. Gastric mucosal responses to intrahepatic portosystemic shunting in patients with cirrhosis. Gastroenterology 2000; 118 (05) 905-911
    CrossrefPubMedGoogle Scholar
  • 46 Chen PH, Hou MC, Hsin IF, Wang YP. Magnifying endoscopy with narrow band imaging is superior to histology for the diagnosis of gastric antral vascular ectasia in cirrhotic patients. Gastrointest Endosc 2016; 83 (5S) x
    Google Scholar
  • 47 Yao K. How is the VS (vessel plus surface) classification system applicable to magnifying narrow-band imaging examinations of gastric neoplasias initially diagnosed as low-grade adenomas?. Gastric Cancer 2012; 15 (02) 118-120
    CrossrefPubMedGoogle Scholar
  • 48 Kanzaki H, Uedo N, Ishihara R. et al. Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis. Helicobacter 2012; 17 (03) 224-231
    CrossrefPubMedGoogle Scholar
  • 49 Kanemitsu T, Yao K, Nagahama T. et al. The vessels within epithelial circle (VEC) pattern as visualized by magnifying endoscopy with narrow-band imaging (ME-NBI) is a useful marker for the diagnosis of papillary adenocarcinoma: a case-controlled study. Gastric Cancer 2014; 17 (03) 469-477
    CrossrefPubMedGoogle Scholar
  • 50 Nakayoshi T, Tajiri H, Matsuda K, Kaise M, Ikegami M, Sasaki H. Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video). Endoscopy 2004; 36 (12) 1080-1084
    Article in Thieme ConnectPubMedGoogle Scholar
  • 51 Kanesaka T, Sekikawa A, Tsumura T. et al. Absent microsurface pattern is characteristic of early gastric cancer of undifferentiated type: magnifying endoscopy with narrow-band imaging. Gastrointest Endosc 2014; 80 (06) 1194-1198.e1
    CrossrefPubMedGoogle Scholar