Comparison between Narrow Band Imaging Technology and Methylene Blue Chromoendoscopy in Early Detection of Barrett’s Esophagus

Albana, Amany Ahmed Sorour; Abdelaaty, Ehab; Alsedfy, Amel Sobhy Mahmoud; Abdelgawad, Zeinab Madian Elattar Madian; Mostafa, Neveen Rashad

doi:10.21608/svuijm.2025.419449.2269

Comparison between Narrow Band Imaging Technology and Methylene Blue Chromoendoscopy in Early Detection of Barrett’s Esophagus

Document Type : Original research articles

Authors

¹ Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt

² Department of Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt.

³ Department of Clinical & Experimental Internal Medicine, Medical Research Institute, Alexandria University, Alexandria, Egypt.

10.21608/svuijm.2025.419449.2269

Abstract

Background: Gastroesophageal reflux disease (GERD) is a chronic lower esophageal disorder with a variant global prevalence. Barrett's esophagus (BE) represents the replacement of the normal squamous epithelium lining of the lower esophagus by a specialized columnar epithelium and is a forerunner of esophageal adenocarcinoma (EAC). The EAC prevention paradigm relies on endoscopic monitoring of BE to identify dysplastic changes and deliver effective endoscopic treatment.
Objectives: are an assessment of the diagnostic effectiveness of narrow-band imaging-targeted (NBI) and methylene blue chromoendoscopy-targeted biopsies (MBCE) using high-resolution upper gastrointestinal endoscopy (HR-UDIE) compared to four-quadrant biopsies, using conventional upper gastrointestinal endoscopy (C-UGIE) as the gold standard for comparison.
Patients and methods: Fifty patients were clinically evaluated and underwent C-UGIE using a video endoscopy system, Olympus GIF 240, to obtain four-quadrant biopsies from any salmon-colored mucosa or visible suspicious lesion extending for ≥1 cm proximal to the gastroesophageal junction. Six weeks later, all patients were re-examined using HR-UGIE (EVIS X1), and biopsy taking was performed using either NBI or MBCE.
Results: Pathological examinations of the four-quadrant biopsies obtained by the C-UGIE detected variant pathological diagnoses, including BE with different degrees of dysplasia, and three patients had EAC. Pathological diagnoses of biopsies obtained by NBI or chromoendoscopy were comparable (P = 0.939). The diagnostic performance of NBI and MBCE for BE and EAC was comparable and matched with the result of the gold standard method.
Conclusion: Both NBI and MBCE can be effectively applied for BE screening in patients with chronic GERD.

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