Journal Article

Comparison of Effective Imaging Modalities for Detecting Gastric Neoplasms: A Randomized 3-Arm Phase II Trial

Manabu Muto, Yuki Okubo, Seiichiro Abe, Masashi Tamaoki, Azusa Kawasaki, Keiichiro Nakajo, Noriya Uedo, Takashi Ikeno, Hideki Furuya, Satoru Nonaka, Chikatoshi Katada, Yasuhiro Tani, Masashi Wakabayashi, Tomonori Yano, Tatsuro Murano, Tomohiro Kadota, Yasuaki Furue, Akinori Watanabe, Naohiro Yoshida, Akira Yokoyama, Hisashi Doyama, Hiroyuki Takamaru

2024

Overview

INTRODUCTION:The early detection of gastric neoplasms (GNs) leads to favorable treatment outcomes. The latest endoscopic system, EVIS X1, includes third-generation narrow-band imaging (3G-NBI), texture and color enhancement imaging (TXI), and high-definition white-light imaging (WLI). Therefore, this randomized phase II trial aimed to identify the most promising imaging modality for GN detection using 3G-NBI and TXI.METHODS:Patients with scheduled surveillance endoscopy after a history of esophageal cancer or GN or preoperative endoscopy for known esophageal cancer or GN were randomly assigned to the 3G-NBI, TXI, or WLI groups. Endoscopic observations were performed to detect new GN lesions, and all suspected lesions were biopsied. The primary endpoint was the GN detection rate during primary observation. Secondary endpoints were the rate of missed GNs, early gastric cancer detection rate, and positive predictive value for a GN diagnosis. The decision rule had a higher GN detection rate between 3G-NBI and TXI, outperforming WLI by >1.0%.RESULTS:Finally, 901 patients were enrolled and assigned to the 3G-NBI, TXI, and WLI groups (300, 300, and 301 patients, respectively). GN detection rates in the 3G-NBI, TXI, and WLI groups were 7.3, 5.0, and 5.6%, respectively. The rates of missed GNs were 1.0, 0.7, and 1.0%, the detection rates of early gastric cancer were 5.7, 4.0, and 5.6%, and the positive predictive values for the diagnosis of GN were 36.5, 21.3, and 36.8% in the 3G-NBI, TXI, and WLI groups, respectively.DISCUSSION:Compared with TXI and WLI, 3G-NBI is a more promising modality for GN detection.

• Publisher: Ovid Technologies (Wolters Kluwer Health),Wolters Kluwer,Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subject: Aged / Atrophy / Biopsy / Cancer therapies / Clinical outcomes / Early Detection of Cancer - methods / Endoscopy / Esophageal cancer / Esophageal Neoplasms - diagnosis / Esophageal Neoplasms - diagnostic imaging / Female / Gastric cancer / Gastroscopy - methods / Health surveillance / Humans / Male / Medical imaging / Middle Aged / Narrow Band Imaging - methods / Patients / Predictive Value of Tests / Stomach / Stomach Neoplasms - diagnosis / Stomach Neoplasms - diagnostic imaging / Surveillance / Tumors