PMID- 28732392
OWN - NLM
STAT- MEDLINE
DCOM- 20180718
LR  - 20220321
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 49
IP  - 12
DP  - 2017 Dec
TI  - Systematic assessment with I-SCAN magnification endoscopy and acetic acid 
      improves dysplasia detection in patients with Barrett's esophagus.
PG  - 1219-1228
LID - 10.1055/s-0043-113441 [doi]
AB  - Background and study aims Enhanced endoscopic imaging with chromoendoscopy may 
      improve dysplasia recognition in patients undergoing assessment of Barrett's 
      esophagus (BE). This may reduce the need for random biopsies to detect more 
      dysplasia. The aim of this study was to assess the effect of magnification 
      endoscopy with I-SCAN (Pentax, Tokyo, Japan) and acetic acid (ACA) on dysplasia 
      detection in BE using a novel mucosal and vascular classification system. 
      Methods BE segments and suspicious lesions were recorded with high definition 
      white-light and magnification endoscopy enhanced using all I-SCAN modes in 
      combination. We created a novel mucosal and vascular classification system based 
      on similar previously validated classifications for narrow-band imaging (NBI). A 
      total of 27 videos were rated before and after ACA application. Following 
      validation, a further 20 patients had their full endoscopies recorded and 
      analyzed to model use of the system to detect dysplasia in a routine clinical 
      scenario. Results The accuracy of the I-SCAN classification system for BE 
      dysplasia improved with I-SCAN magnification from 69 % to 79 % post-ACA 
      (P = 0.01). In the routine clinical scenario model in 20 new patients, accuracy 
      of dysplasia detection increased from 76 % using a "pull-through" alone to 83 % 
      when ACA and magnification endoscopy were combined (P = 0.047). Overall 
      interobserver agreement between experts for dysplasia detection was substantial 
      (0.69). Conclusions A new I-SCAN classification system for BE was validated 
      against similar systems for NBI with similar outcomes. When used in combination 
      with magnification and ACA, the classification detected BE dysplasia in clinical 
      practice with good accuracy.Trials registered at ISRCTN (58235785).
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Lipman, Gideon
AU  - Lipman G
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
FAU - Bisschops, Raf
AU  - Bisschops R
AD  - Universitaire Ziekenhuizen Leuven, Leuven, Belgium.
FAU - Sehgal, Vinay
AU  - Sehgal V
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
FAU - Ortiz-Fernandez-Sordo, Jacobo
AU  - Ortiz-Fernandez-Sordo J
AD  - NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham 
      University Hospitals NHS Trust, Nottingham, United Kingdom.
FAU - Sweis, Rami
AU  - Sweis R
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
FAU - Esteban, Jose M
AU  - Esteban JM
AD  - Hospital Clinico San Carlos, Madrid, Spain.
FAU - Hamoudi, Rifat
AU  - Hamoudi R
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Sharjah Institute for Medical Research, College of Medicine, University of 
      Sharjah, Sharjah, United Arab Emirates.
FAU - Banks, Matthew R
AU  - Banks MR
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
FAU - Ragunath, Krish
AU  - Ragunath K
AD  - NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham 
      University Hospitals NHS Trust, Nottingham, United Kingdom.
FAU - Lovat, Laurence B
AU  - Lovat LB
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
FAU - Haidry, Rehan J
AU  - Haidry RJ
AD  - Division of Surgery and Interventional Science, University College London, United 
      Kingdom.
AD  - Department of Gastroenterology, University College Hospital NHS Foundation Trust, 
      London, United Kingdom.
LA  - eng
GR  - II-FS-0509-12051/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Validation Study
DEP - 20170721
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
RN  - 0 (Indicators and Reagents)
RN  - Q40Q9N063P (Acetic Acid)
SB  - IM
CIN - Endoscopy. 2017 Dec;49(12):1291-1292. PMID: 29186741
MH  - Acetic Acid
MH  - Aged
MH  - Aged, 80 and over
MH  - Barrett Esophagus/*classification/*diagnostic imaging/pathology
MH  - Endoscopy, Gastrointestinal/*methods
MH  - Esophageal Mucosa/blood supply/*diagnostic imaging/pathology
MH  - Female
MH  - Humans
MH  - Indicators and Reagents
MH  - Male
MH  - Microvessels/diagnostic imaging
MH  - Middle Aged
MH  - Observer Variation
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
COIS- Competing interests: Dr. Haidry has received research grant support from Pentax 
      Medical, Cook Endoscopy, and Covidien plc to support research infrastructure. Dr. 
      Ragunath has received research grant support from Pentax Medical.
EDAT- 2017/07/22 06:00
MHDA- 2018/07/19 06:00
CRDT- 2017/07/22 06:00
PHST- 2017/07/22 06:00 [pubmed]
PHST- 2018/07/19 06:00 [medline]
PHST- 2017/07/22 06:00 [entrez]
AID - 10.1055/s-0043-113441 [doi]
PST - ppublish
SO  - Endoscopy. 2017 Dec;49(12):1219-1228. doi: 10.1055/s-0043-113441. Epub 2017 Jul 
      21.