Systematic review of narrow-band imaging for the detection and differentiation of abnormalities in the esophagus and stomach (with video)

Since the introduction of NBI, several studies have been performed that investigated the use of NBI in the upper digestive tract. In this review we have systematically reviewed the published literature. With respect to the detection of early neoplastic lesions in the upper digestive tract NBI seems to be very promising for improving the detection of early squamous cell carcinomas and may be an easy alternative to Lugol's solution. Yet more and bigger randomized studies are needed to confirm these initial findings. Another potential indication of NBI may be to improve the sensitivity of endoscopy for GERD. Because only 1 study thoroughly investigated this, we need more and larger studies to determine the role of NBI in the assessment of GERD. By far, most studies on NBI in the esophagus have been published on BE. NBI has shown to have a high accuracy for differentiating SIM from gastric mucosa and nondysplastic BE for HGD/Ca by magnification endoscopy. Whether NBI also improves the detection of early neoplastic lesions in BE is, however, still unclear. Because only a few feasibility studies on the use of NBI in the stomach have been published, the role of NBI in the stomach has not yet been elucidated. Many investigators are actively pursuing studies of NBI, and we anticipate that future studies will help to further clarify the role of NBI for detection and differentiation of distinct conditions of the esophagus and stomach. © 2009 American Society for Gastrointestinal Endoscopy.