Published online Feb 16, 2015. doi: 10.4253/wjge.v7.i2.110
Peer-review started: August 26, 2014
First decision: October 14, 2014
Revised: October 29, 2014
Accepted: December 3, 2014
Article in press: December 3, 2014
Published online: February 16, 2015
Narrow band imaging (NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy (NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists.
Core tip: The article summarizes recent data regarding the potentials of one of the most advanced endoscopic technique used in clinical practice. There are many classification systems of mucosal and vascular patterns already reported in literature, therefore a review could be useful for a better systematization of data. Strategies and challenges in the application of the method in routine practice represent another issue of interest in this article. The picture selection actually reflects the work in the endoscopy department and could serve as a tool in the learning process.