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Indian Journal of Gastroenterology

, Volume 33, Issue 5, pp 440–444 | Cite as

Use of narrow band imaging in assessing duodenal villous atrophy

  • Amitava GoswamiEmail author
  • Sunil Dadhich
  • Narendra Bhargava
Original Article

Abstract

Background and Objective

Narrow band imaging endoscopy with magnification (NBI-ME) has already been established in Barrett’s esophagus, stomach, and colonic mucosa, but limited work has been done in the mucosal evaluation of duodenum. A study was done to determine the correlation between NBI and histology in grading villous architecture in varied etiology.

Method

A prospective observational study comprising 105 subjects with suspected malabsorption. The presence of a diagnosed celiac disease, severe life threatening comorbidity, or pregnancy was considered as exclusion criteria. Standard endoscopy (SE), NBI-ME, multiple duodenal biopsies with histopathological examination were done in all.

Results

Fifty-one patients had celiac disease while 54 patients comprised mainly functional dyspepsia, iron deficiency anemia, tropical malabsorption syndrome, and irritable bowel syndrome. Four NBI-ME image subtypes of villous morphology have been proposed (NBI type I/II/III/IV). NBI-ME had 95 % sensitivity, 90.2 % specificity, 91.2 % positive predictive value, and 94.2 % negative predictive value for diagnosing altered villous morphology. Intraobserver kappa agreement coefficient (κ) for NBI-ME was 0.83 while interobserver agreement was 0.89 (95 % CI 0.8–0.97).

Conclusion

NBI-ME has good performance characteristics and very good kappa intra/interobserver agreement coefficient for varied subtypes of villous morphology. NBI-ME is most useful for obtaining a targeted biopsy which can be missed by conventional white light endoscopy.

Keywords

Celiac disease Narrow band imaging image subtypes Narrow band imaging with magnifying endoscopy Negative predictive value Positive predictive value Sensitivity Specificity Standard endoscopy 

Notes

Conflict of interest

AG, SD, and NB all declare that they have no conflict of interest.

Ethical statement

The study was performed in a manner to conform to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning Informed Consent as shown on Springer.com.

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Copyright information

© Indian Society of Gastroenterology 2014

Authors and Affiliations

  • Amitava Goswami
    • 1
    Email author
  • Sunil Dadhich
    • 1
  • Narendra Bhargava
    • 1
  1. 1.Department of GastroenterologyDr. Sampurnanand Medical CollegeJodhpurIndia

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