Assessment of Still and Moving Images in the Diagnosis of Gastric Lesions Using Magnifying Narrow-Band Imaging in a Prospective Multicenter Trial

<div><p>Objectives</p><p>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.</p><p>Design</p><p>A prospective multicenter cohort study.</p><p>Methods</p><p>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.</p><p>Results</p><p>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.</p><p>Conclusions</p><p>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.</p><p>Trial registration</p><p>Umin.ac.jp <a href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000009477&language=E" target="_blank">UMIN-CTR000008048</a></p></div

Cancerous lesion: Within a DL (arrows), irregular MVP and irregular MSP are noted.

<p>Cancerous lesion: Within a DL (arrows), irregular MVP and irregular MSP are noted.</p

Characteristics of 40 Gastric Lesions Used in Both Tests.

<p>Characteristics of 40 Gastric Lesions Used in Both Tests.</p

M-NBI findings of 40 Gastric Lesions Used in Both Tests.

<p>M-NBI findings of 40 Gastric Lesions Used in Both Tests.</p

Non-cancerous lesion (gastritis): Absent DL, regular MVP, and regular MSP are noted.

<p>Non-cancerous lesion (gastritis): Absent DL, regular MVP, and regular MSP are noted.</p

Diagnostic Accuracy of Still Image Test versus Moving Image Test in the Subgroups of Endoscopic Findings.

<p>Diagnostic Accuracy of Still Image Test versus Moving Image Test in the Subgroups of Endoscopic Findings.</p