Narrow-Band Imaging in the Diagnosis of Barrett's Esophagus

Barrett's esophagus (BE) is the premalignant lesion for the majority of patients with esophageal and gastroesophageal junction adenocarcinoma, a cancer rapidly rising in incidence in the United States and western Europe. Endoscopic diagnosis of BE and neoplasia arising from within a BE segment continues to be a challenge and is typically dependent on random biopsies. Because of the focal and patchy nature of intestinal metaplasia and neoplasia, novel endoscopic approaches aimed at improving current screening and surveillance strategies have been explored. Narrow-band imaging (NBI) with or without magnification endoscopy is a new endoscopic technique that changes the optical filters of the current sequential lighting video endoscopes to spectral narrow-band filters. Use of a higher intensity of blue light with narrow-band filters allows detailed imaging of mucosal and vascular surface patterns with a high degree of resolution. Studies to date have yielded promising results for NBI alone or in combination with other advanced endoscopic techniques in the detection and surveillance of patients with BE.