DETECTION OF GASTRIC PREMALIGNANT CONDITIONS AMONG NON-EXPERT ENDOSCOPISTS ON OPTICAL DIAGNOSIS USING A NEW VIRTUAL CHROMOENDOSCOPY DEVELOPED BY SONOSCAPE

Aims Endoscopic recognition of gastric premalignant conditions (GPC) is the first step before taking biopsies. High-definition (HD) endoscopes and virtual chromoendoscopy (VC) improve the detection of GPC. We aimed to evaluate the diagnostic accuracy for GPC among non-expert endoscopists.

Methods Routine gastroscopies were performed prospectively in a community setting for three months by using HD endoscopes and the VC developed by Sonoscape: SFI and VIST. Four non-expert endoscopists were enrolled. Endoscopic diagnosis of GPC were findings described in the Kimura-Takemoto and Simplified-NBI classification. Biopsies were obtained according to Sydney protocol. Patients were categorized endoscopically and histologically into two categories: presence or absence of GPC. Histologically, OLGA III/IV, OLGIM III/IV, and dysplasia were considered advanced GPC.

Results We included 147 patients (mean age 57±18, 61% women). Histologically, 55(37%) patients had GPC, 15 (10%) were AG, 32 (22%) IM, and 8(5%) dysplasia. Twenty-two(15%) patients had advanced GPC, 2(1.4%) were OLGA III/IV, 12(8.2%) OLGIM III/IV, and 8 (5.4%) dysplasia. Seven(13%) patients out of 54 without GPC at endoscopy had the presence of this condition in histology, but only one(2%) case was advanced GPC in histology (it was OLGIM IV). The global diagnostic yield for presence or absence of GPC was: sensibility 87%, specificity 51%, positive predictive value (PPV) 52%, negative predictive value (NPV) 87%, and diagnostic accuracy 65%.

Conclusions Non-experts endoscopists had low accuracy on GPC diagnosis. However, the high sensibility and NPV using this new technology represent an opportunity to reduce gastric biopsies with a low risk to miss patients at higher risk for GC.

Publication History

Article published online:
14 April 2022