Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis

Takuya Inoue, Noriya Uedo, Ryu Ishihara, Tsukasa Kawaguchi, Natsuko Kawada, Rika Chatani, Takashi Kizu, Chie Tamai, Yoji Takeuchi, Koji Higashino, Hiroyasu Iishi, Masaharu Tatsuta, Yasuhiko Tomita, E. Tóth

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Purpose: Diagnosis of chronic atrophic fundal gastritis (CAFG) is important to understand the pathogenesis of gastric diseases and assess the risk of gastric cancer. Autofluorescence imaging videoendoscopy (AFI) may enable the detection of mucosal features not apparent by conventional white-light endoscopy. The purpose of this study was to estimate the diagnostic ability of AFI in CAFG. Methods: A total of 77 patients were enrolled. Images of the gastric body in AFI and white-light mode were taken to assess the extent of gastritis, and biopsies were taken from green (n = 119) and purple (n = 146) mucosa in AFI images. The diagnostic accuracy of green mucosa for CAFG was investigated according to the Sydney system. Results: In per-patient analysis, the accuracy of green mucosa in patients with activity, inflammation, atrophy and intestinal metaplasia was 64, 93, 88 and 81%, respectively. In per-biopsy analysis, the accuracy for activity, inflammation, atrophy and intestinal metaplasia was 55, 62, 76 and 76%, respectively. Green areas in the gastric body exhibited more inflammation (p <0.001), atrophy (p <0.001) and intestinal metaplasia (p <0.001), whereas purple areas rarely contained atrophy or intestinal metaplasia. The kappa statistics for inter- and intra-observer agreement of AFI on assessing the extent of CAFG were 0.66 and 0.47, while those for white-light endoscopy were 0.56 and 0.39. Conclusions: AFI could diagnose the extent of CAFG as a green area in the gastric body, with higher reproducibility compared with white-light endoscopy. Therefore, AFI may be a useful adjunct to endoscopy to identify patients at high risk of developing gastric cancer.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalJournal of Gastroenterology
Volume45
Issue number1
DOIs
Publication statusPublished - Jan 2010

Fingerprint

Atrophic Gastritis
Optical Imaging
Metaplasia
Endoscopy
Atrophy
Light
Stomach
Mucous Membrane
Inflammation
Stomach Neoplasms
Biopsy
Stomach Diseases
Body Image
Gastritis

Keywords

  • Atrophic gastritis
  • Autofluorescence endoscopy
  • Helicobacter pylori
  • Image-enhanced endoscopy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis. / Inoue, Takuya; Uedo, Noriya; Ishihara, Ryu; Kawaguchi, Tsukasa; Kawada, Natsuko; Chatani, Rika; Kizu, Takashi; Tamai, Chie; Takeuchi, Yoji; Higashino, Koji; Iishi, Hiroyasu; Tatsuta, Masaharu; Tomita, Yasuhiko; Tóth, E.

In: Journal of Gastroenterology, Vol. 45, No. 1, 01.2010, p. 45-51.

Research output: Contribution to journalArticle

Inoue, T, Uedo, N, Ishihara, R, Kawaguchi, T, Kawada, N, Chatani, R, Kizu, T, Tamai, C, Takeuchi, Y, Higashino, K, Iishi, H, Tatsuta, M, Tomita, Y & Tóth, E 2010, 'Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis', Journal of Gastroenterology, vol. 45, no. 1, pp. 45-51. https://doi.org/10.1007/s00535-009-0150-7
Inoue, Takuya ; Uedo, Noriya ; Ishihara, Ryu ; Kawaguchi, Tsukasa ; Kawada, Natsuko ; Chatani, Rika ; Kizu, Takashi ; Tamai, Chie ; Takeuchi, Yoji ; Higashino, Koji ; Iishi, Hiroyasu ; Tatsuta, Masaharu ; Tomita, Yasuhiko ; Tóth, E. / Autofluorescence imaging videoendoscopy in the diagnosis of chronic atrophic fundal gastritis. In: Journal of Gastroenterology. 2010 ; Vol. 45, No. 1. pp. 45-51.
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abstract = "Purpose: Diagnosis of chronic atrophic fundal gastritis (CAFG) is important to understand the pathogenesis of gastric diseases and assess the risk of gastric cancer. Autofluorescence imaging videoendoscopy (AFI) may enable the detection of mucosal features not apparent by conventional white-light endoscopy. The purpose of this study was to estimate the diagnostic ability of AFI in CAFG. Methods: A total of 77 patients were enrolled. Images of the gastric body in AFI and white-light mode were taken to assess the extent of gastritis, and biopsies were taken from green (n = 119) and purple (n = 146) mucosa in AFI images. The diagnostic accuracy of green mucosa for CAFG was investigated according to the Sydney system. Results: In per-patient analysis, the accuracy of green mucosa in patients with activity, inflammation, atrophy and intestinal metaplasia was 64, 93, 88 and 81{\%}, respectively. In per-biopsy analysis, the accuracy for activity, inflammation, atrophy and intestinal metaplasia was 55, 62, 76 and 76{\%}, respectively. Green areas in the gastric body exhibited more inflammation (p <0.001), atrophy (p <0.001) and intestinal metaplasia (p <0.001), whereas purple areas rarely contained atrophy or intestinal metaplasia. The kappa statistics for inter- and intra-observer agreement of AFI on assessing the extent of CAFG were 0.66 and 0.47, while those for white-light endoscopy were 0.56 and 0.39. Conclusions: AFI could diagnose the extent of CAFG as a green area in the gastric body, with higher reproducibility compared with white-light endoscopy. Therefore, AFI may be a useful adjunct to endoscopy to identify patients at high risk of developing gastric cancer.",
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AU - Kawada, Natsuko

AU - Chatani, Rika

AU - Kizu, Takashi

AU - Tamai, Chie

AU - Takeuchi, Yoji

AU - Higashino, Koji

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AU - Tomita, Yasuhiko

AU - Tóth, E.

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