Advanced imaging (narrow band and acetic acid chromoendoscopy) and guided biopsies in surveillance of Barrett’s oesophagus: a systematic review

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This systematic review synthesizes evidence on narrow band imaging (NBI) and acetic acid chromoendoscopy (AAC) for Barrett’s oesophagus surveillance.
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The review included 44 interventional studies, indicating that NBI-targeted biopsies are more effective for dysplasia detection than white light endoscopy.
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AAC demonstrated higher sensitivity for neoplasia detection compared to white light endoscopy, while reducing the number of required biopsies.
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Neither NBI nor AAC can replace the Seattle protocol due to the risk of missing neoplasia.
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The study emphasizes the need for high-quality randomized controlled trials to evaluate advanced imaging techniques in Barrett’s oesophagus surveillance.

Bmj Open Gastroenterology

by Champika Gamakaranage, Thomas David Butler, Elizabeth Ratcliffe, James Britton, Richard Keld, Neeraj Prasad, Shaheen Hamdy, John McLaughlin, Yeng Ang
March 13, 2026

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