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Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis

Inoue T, T ; Uedo, N ; Ishihara, R ; Kawaguchi, T ; Kawada, N ; Chatani, R ; Kizu, T ; Tamai, C ; Takeuchi, J and Higashino, K , et al. (2010) In Journal of Gastroenterology 45(1). p.45-51
Abstract
Purpose: Diagnosis of chronic atrophic fundal gastritis (CAFG) is important to understand the pathogenesis of gastric diseases and assess the risk of gastric cancer. Autofluorescence imaging videoendoscopy (AFI) may

enable the detection of mucosal features not apparent by conventional white-light endoscopy. The purpose of this study was to estimate the diagnostic ability of AFI in CAFG.

Methods: A total of 77 patients were enrolled. Images of the gastric body in AFI and white-light mode were taken to assess the extent of gastritis, and biopsies were taken from green (n = 119) and purple (n = 146) mucosa in AFI images. The diagnostic accuracy of green mucosa for CAFG was investigated according to the Sydney... (More)
Purpose: Diagnosis of chronic atrophic fundal gastritis (CAFG) is important to understand the pathogenesis of gastric diseases and assess the risk of gastric cancer. Autofluorescence imaging videoendoscopy (AFI) may

enable the detection of mucosal features not apparent by conventional white-light endoscopy. The purpose of this study was to estimate the diagnostic ability of AFI in CAFG.

Methods: A total of 77 patients were enrolled. Images of the gastric body in AFI and white-light mode were taken to assess the extent of gastritis, and biopsies were taken from green (n = 119) and purple (n = 146) mucosa in AFI images. The diagnostic accuracy of green mucosa for CAFG was investigated according to the Sydney system.

Results: In per-patient analysis, the accuracy of green mucosa in patients with activity, inflammation, atrophy and intestinal metaplasia was 64, 93, 88 and 81%, respectively. In per-biopsy analysis, the accuracy for activity, inflammation, atrophy and intestinal metaplasia was 55, 62, 76

and 76%, respectively. Green areas in the gastric body exhibited more inflammation (p\0.001), atrophy (p\0.001) and intestinal metaplasia (p\0.001), whereas purple areas rarely contained atrophy or intestinal metaplasia. The kappa statistics for inter- and intra-observer

agreement of AFI on assessing the extent of CAFG were 0.66 and 0.47, while those for white-light endoscopy were 0.56 and 0.39.

Conclusions: AFI could diagnose the extent of CAFG as a green area in the gastric body, with higher reproducibility compared with white-light endoscopy. Therefore, AFI may be a useful adjunct to endoscopy to identify patients at high risk of developing gastric cancer. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Image-enhanced endoscopy, Autofluorescence endoscopy, Helicobacter pylori, Atrophic gastritis
in
Journal of Gastroenterology
volume
45
issue
1
pages
45 - 51
publisher
Springer
external identifiers
  • wos:000273811100007
  • scopus:77949275796
  • pmid:19876586
ISSN
0944-1174
DOI
10.1007/s00535-009-0150-7
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
id
b3cea1e8-26a1-4be2-addc-9200da71f5f1 (old id 1542396)
date added to LUP
2016-04-01 14:33:55
date last changed
2022-02-27 03:17:50
@article{b3cea1e8-26a1-4be2-addc-9200da71f5f1,
  abstract     = {{Purpose: Diagnosis of chronic atrophic fundal gastritis (CAFG) is important to understand the pathogenesis of gastric diseases and assess the risk of gastric cancer. Autofluorescence imaging videoendoscopy (AFI) may<br/><br>
enable the detection of mucosal features not apparent by conventional white-light endoscopy. The purpose of this study was to estimate the diagnostic ability of AFI in CAFG.<br/><br>
Methods: A total of 77 patients were enrolled. Images of the gastric body in AFI and white-light mode were taken to assess the extent of gastritis, and biopsies were taken from green (n = 119) and purple (n = 146) mucosa in AFI images. The diagnostic accuracy of green mucosa for CAFG was investigated according to the Sydney system.<br/><br>
Results: In per-patient analysis, the accuracy of green mucosa in patients with activity, inflammation, atrophy and intestinal metaplasia was 64, 93, 88 and 81%, respectively. In per-biopsy analysis, the accuracy for activity, inflammation, atrophy and intestinal metaplasia was 55, 62, 76<br/><br>
and 76%, respectively. Green areas in the gastric body exhibited more inflammation (p\0.001), atrophy (p\0.001) and intestinal metaplasia (p\0.001), whereas purple areas rarely contained atrophy or intestinal metaplasia. The kappa statistics for inter- and intra-observer<br/><br>
agreement of AFI on assessing the extent of CAFG were 0.66 and 0.47, while those for white-light endoscopy were 0.56 and 0.39. <br/><br>
Conclusions: AFI could diagnose the extent of CAFG as a green area in the gastric body, with higher reproducibility compared with white-light endoscopy. Therefore, AFI may be a useful adjunct to endoscopy to identify patients at high risk of developing gastric cancer.}},
  author       = {{Inoue T, T and Uedo, N and Ishihara, R and Kawaguchi, T and Kawada, N and Chatani, R and Kizu, T and Tamai, C and Takeuchi, J and Higashino, K and Iishi, H and Tatsuta, M and Tomita, Y and Toth, Ervin}},
  issn         = {{0944-1174}},
  keywords     = {{Image-enhanced endoscopy; Autofluorescence endoscopy; Helicobacter pylori; Atrophic gastritis}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{45--51}},
  publisher    = {{Springer}},
  series       = {{Journal of Gastroenterology}},
  title        = {{Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis}},
  url          = {{http://dx.doi.org/10.1007/s00535-009-0150-7}},
  doi          = {{10.1007/s00535-009-0150-7}},
  volume       = {{45}},
  year         = {{2010}},
}