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Diagnostic accuracy of narrow‐band imaging endoscopy with targeted biopsies compared with standard endoscopy with random biopsies in patients with Barrett's esophagus: A systematic review and meta‐analysis
Author(s) -
Hajelssedig Omer Eljyli,
Zorron Cheng Tao Pu Leonardo,
Thompson Jacqueline Y,
Lord Anton,
El Sayed Iman,
Meyer Chase,
Shaukat Ali Faisal,
Abdulazeem Hebatullah M,
Kheir Ammar O,
Siepmann Timo,
Singh Rajvinder
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15577
Subject(s) - medicine , barrett's esophagus , dysplasia , meta analysis , endoscopy , confidence interval , esophagus , biopsy , radiology , receiver operating characteristic , predictive value of tests , narrow band imaging , adenocarcinoma , cancer
Background and Aim Endoscopic surveillance for dysplasia in Barrett's esophagus (BE) with random biopsies is the primary diagnostic tool for monitoring clinical progression into esophageal adenocarcinoma. As an alternative, narrow‐band imaging (NBI) endoscopy offers targeted biopsies that can improve dysplasia detection. This study aimed to evaluate NBI‐guided targeted biopsies' diagnostic accuracy for detecting dysplasia in patients undergoing endoscopic BE surveillance compared with the widely used Seattle protocol. Methods Cochrane DTA Register, MEDLINE/PubMed, EMBASE, OpenGrey, and bibliographies of identified papers were searched until 2018. Two independent investigators resolved discrepancies by consensus, study selection, data extraction, and quality assessment. Data on sensitivity, specificity, and predictive values were pooled and analyzed using a random‐effects model. Results Of 9528 identified articles, six studies comprising 493 participants were eligible for quantitative synthesis. NBI‐targeted biopsy showed high diagnostic accuracy in detection of dysplasia in BE with a sensitivity of 76% (95% confidence interval [CI]: 0.61–0.91), specificity of 99% (95% CI: 0.99–1.00), positive predictive value of 97% (95% CI: 0.96–0.99), and negative predictive value of 84% (95% CI: 0.69–0.99) for detection of all grades of dysplasia. The receiver‐operating characteristic curve for NBI model performance was 0.8550 for detecting all dysplasia. Conclusion Narrow‐band imaging‐guided biopsy demonstrated high diagnostic accuracy and might constitute a valid substitute for random biopsies during endoscopic surveillance for dysplasia in BE.