Role of magnifying narrow-band imaging endoscopy for diagnosis of Helicobacter pylori infection and gastric precancerous conditions: Few issues

Abstract

Standard endoscopy with biopsy and narrow-band imaging with guided biopsy are techniques for the detection of Helicobacter pylori (H. pylori)-related gastritis and precancerous lesions. In this study, the authors compared standard endoscopy and magnified narrow-band imaging (commonly known as NBI-M) in the diagnosis of H. pylori infections, atrophic gastritis, and intestinal metaplasia. Although the sensitivity of NBI-M is better than standard endoscopy, the diagnostic accuracy did not differ substantially between the diagnostic modalities. Future prospective studies may guide endoscopists in difficult cases regarding which modality is more useful and cost-effective for the diagnosis of H. pylori-related gastritis and precancerous conditions.

Keywords: Standard endoscopy, Magnified narrow band imaging, Helicobacter pylori, Atrophic gastritis, Intestinal metaplasia, Pepsinogen

Core Tip: Magnified narrow band imaging (NBI-M) is used for diagnosis of dysplastic and cancerous lesions. The study is the first of its kind to evaluate this modality for detection of Helicobacter pylori related gastritis and precancerous lesions. A procedure to be widely accepted should be cost effective and less time consuming. Whereas white light endoscopy is commonly used by endoscopist to detect any cancer or precancerous lesions, formal endoscopic training regarding use of NBI-M enhances feasibility and detection rate. Whether the combination of NBI-M and artificial intelligence can replace biopsy remains a million dollar question.