Clinical Scorecard: Utilization of Narrow Band Imaging and Acetic Acid Chromoendoscopy for Barrett’s Oesophagus Surveillance: A Systematic Review of Evidence

At a Glance

Key Highlights

• NBI-targeted biopsies are more effective in dysplasia detection than white light endoscopy.
• AAC shows higher sensitivity for neoplasia detection compared to white light endoscopy.
• Neither NBI nor AAC can replace the Seattle protocol for biopsies due to neoplasia missing rates.
• Advanced imaging techniques may reduce the number of biopsies needed.
• Regular surveillance intervals are recommended at 6 months to 5 years.

Guideline-Based Recommendations

Diagnosis

• Biopsy confirmation of specialized columnar epithelium and intestinal metaplasia is essential for Barrett’s Oesophagus diagnosis.

Management

• Surveillance endoscopy should utilize advanced imaging techniques to improve dysplasia detection.

Monitoring & Follow-up

• Regular surveillance intervals of 6 months to 5 years are recommended.

Risks

• Sampling errors and labour intensity associated with the Seattle protocol biopsies.

Patient & Prescribing Data

Patients with Barrett’s Oesophagus at risk for neoplastic transformation.

Incorporation of NBI and AAC may improve detection rates and reduce biopsy burden.

Clinical Best Practices

• Utilize NBI and AAC during surveillance to enhance dysplasia detection.
• Adhere to Seattle protocol for biopsy sampling despite the use of advanced imaging.

Related Resources & Content

• American Society of Gastroenterology (ASGE) systematic review