Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2015; 7(2): 110-120
Published online Feb 16, 2015. doi: 10.4253/wjge.v7.i2.110
Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions
Alina Boeriu, Cristian Boeriu, Silvia Drasovean, Ofelia Pascarenco, Simona Mocan, Mircea Stoian, Daniela Dobru
Alina Boeriu, Silvia Drasovean, Ofelia Pascarenco, Daniela Dobru, Department of Gastroenterology, University of Medicine and Pharmacy Tirgu Mures, 540139 Tirgu Mures, Romania
Cristian Boeriu, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures County Emergency Hospital, 540136 Tirgu Mures, Romania
Simona Mocan, Department of Pathology, Tirgu Mures County Emergency Hospital, 540136 Tirgu Mures, Romania
Mircea Stoian, Department of Anesthesia and Intensive Care, Mures County Hospital, 540000 Tirgu Mures, Romania
Author contributions: Boeriu A, Boeriu C, Pascarenco O and Dobru D contributed equally to this work; Boeriu A, Pascarenco O and Dobru D performed the endoscopies; Boeriu A and Boeriu C performed the literature search; Mocan S performed the histopathological examinations; Stoian M performed the anesthesia for endoscopies; Boeriu A and Drasovean S analyzed the data; Boeriu A and Boeriu C wrote the manuscript.
Conflict-of-interest: The authors attest that there is no conflict of interest such as fees for serving as a speaker, employment, consultancies, research funding, stock ownership, equity interests or patent-licensing arrangements with any organization regarding the material discussed in the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Cristian Boeriu, MD, PhD, Department of Anesthesia Intensive Care and Emergency Medicine, University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures County Emergency Hospital, No.50 Gheorghe Marinescu St., 540136 Tirgu Mures, Romania.
Telephone: +40-723-388810 Fax: +40-265-219102
Received: August 26, 2014
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.

Keywords: Narrow band imaging magnifying endoscopy, Premalignant, Early cancer, Mucosal patterns, Vascular patterns

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.