Background and Aims
Visible lesion (VL) detection is essential in patients with Barrett’s esophagus (BE).
We sought to assess the rate of VL detection by academic and community endoscopists
using high-definition white-light endoscopy (HD-WLE) and narrow-band imaging (NBI)
during surveillance endoscopy.
Methods
Fifty endoscopists were invited to participate in a prospective video survey study.
Participants viewed 25 standardized clips of patients referred for endoscopic therapy.
Participants noted identification of anatomic landmarks and VLs using HD-WLE and NBI
and reported practice-level data. The criterion standard of VL identification was
established by consensus of 5 BE experts. Our primary outcome was the rate of VL identification
using HD-WLE and NBI.
Results
Forty-four of 50 participants completed the study (22 academic and 22 community).
Compared with the criterion standard, participants did not identify 28% (HD-WLE) and
31% (NBI) of VLs. Community endoscopists had more experience (>5 years in practice:
community 85% vs academic 54.5%, P = .041; >5 surveillance endoscopies a month: community 85% vs academic 31.8%, P = .046). Across all participants, VL detection using NBI improved significantly with
a minimum of 5 surveillance endoscopies per month (area under the curve = .72; 95%
confidence interval, .56-.85; P = .006).
Conclusions
Despite improved endoscope resolution and availability of virtual chromoendoscopy,
the overall rate of VL detection remains low. Identification of VLs using NBI may
be volume dependent. Further education and training efforts focused on VL detection
during BE surveillance endoscopy are needed.
Abbreviations:
BE (Barrett’s esophagus), EET (endoscopic eradication therapy), HD-WLE (high-definition white-light endoscopy), NBI (narrow-band imaging), VC (virtual chromoendoscopy), VL (visible lesion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 22, 2022
Accepted:
August 19,
2022
Received:
December 7,
2021
Footnotes
DISCLOSURE: The following authors disclosed financial relationships: C. A. Beveridge: Consultant for Lucid Diagnostics, Inc. A. Rastogi: Consultant for Boston Scientific, Cook Endoscopy, and Olympus; research support from Olympus. V. R. Muthusamy: Consultant for Boston Scientific, Medtronic, and Interpace Diagnostics; research support from Boston Scientific and Medtronic; honoraria from Torax Medical/Ethicon; advisory board for Motus GI and Endogastric Solutions. V. Kushnir: Consultant for Boston Scientific and Medtronic. S. Wani: Consultant for Boston Scientific, Medtronic, Interpace; and Cernostics; research support from the University of Colorado Department of Medicine Outstanding Early Scholars Program. S. Komanduri: Consultant for Boston Scientific Corporation, Medtronic, and Castle Biosciences. All other authors disclosed no financial relationships.
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