Classifying Barrett Esophagus with Narrow-Band Imaging

A new classification system for mucosal and vascular patterns shows promise for improving early detection of dysplasia and cancer.

Narrow-band imaging (NBI) has shown variable results for improving endoscopists' detection of high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) in patients with Barrett esophagus. In an industry-funded study, an international working group developed and validated a prospective, consensus-driven NBI classification system to optimize detection in this setting.

Six endoscopy experts reviewed 60 NBI images of nondysplastic Barrett esophagus, HGD, and EAC, and developed, by consensus, a classification system based on the regularity or irregularity of mucosal and vascular patterns. The working group then validated the system by evaluating images obtained prospectively. In assessing 50 new NBI images, interobserver agreement was …

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors