PLoS ONE (Jan 2014)

Assessment of still and moving images in the diagnosis of gastric lesions using magnifying narrow-band imaging in a prospective multicenter trial.

  • Tomoyuki Hayashi,
  • Hisashi Doyama,
  • Yukihiro Shirota,
  • Hirokazu Tsuji,
  • Youhei Marukawa,
  • Hajime Ohta,
  • Kazuhiro Miwa,
  • Takaharu Masunaga,
  • Shuichi Terasaki,
  • Yutaka Matano,
  • Kunihiro Tsuji,
  • Yoshibumi Kaneko,
  • Toshihide Okada,
  • Hiroshi Kurumaya,
  • Shuichi Kaneko

DOI
https://doi.org/10.1371/journal.pone.0100857
Journal volume & issue
Vol. 9, no. 7
p. e100857

Abstract

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OBJECTIVES: Magnifying narrow-band imaging (M-NBI) is more accurate than white-light imaging for diagnosing small gastric cancers. However, it is uncertain whether moving M-NBI images have additional effects in the diagnosis of gastric cancers compared with still images. DESIGN: A prospective multicenter cohort study. METHODS: To identify the additional benefits of moving M-NBI images by comparing the diagnostic accuracy of still images only with that of both still and moving images. Still and moving M-NBI images of 40 gastric lesions were obtained by an expert endoscopist prior to this prospective multicenter cohort study. Thirty-four endoscopists from ten different Japanese institutions participated in the prospective multicenter cohort study. Each study participant was first tested using only still M-NBI images (still image test), then tested 1 month later using both still and moving M-NBI images (moving image test). The main outcome was a difference in the diagnostic accuracy of cancerous versus noncancerous lesions between the still image test and the moving image test. RESULTS: Thirty-four endoscopists were analysed. There were no significant difference of cancerous versus noncancerous lesions between still and moving image tests in the diagnostic accuracy (59.9% versus 61.5%), sensitivity (53.4% versus 55.9%), and specificity (67.0% versus 67.6%). And there were no significant difference in the diagnostic accuracy between still and moving image tests of demarcation line (65.4% versus 65.5%), microvascular pattern (56.7% versus 56.9%), and microsurface pattern (48.1% versus 50.9%). Diagnostic accuracy showed no significant difference between the still and moving image tests in the subgroups of endoscopic findings of the lesions. CONCLUSIONS: The addition of moving M-NBI images to still M-NBI images does not improve the diagnostic accuracy for gastric lesions. It is reasonable to concentrate on taking sharp still M-NBI images during endoscopic observation and use them for diagnosis. TRIAL REGISTRATION: Umin.ac.jp UMIN-CTR000008048.