研究目的
To evaluate the additional value of blue-light imaging (BLI) over white-light endoscopy (WLE) for visualization and delineation of early neoplasia in Barrett's esophagus.
研究成果
BLI provides significant additional value over WLE for visualizing and delineating Barrett's neoplasia, especially for lesions difficult to delineate with WLE alone. Experts preferred BLI for its superior visualization of surface relief and demarcation lines. Quantitative agreement improved when BLI was used alongside WLE in challenging cases, supporting its clinical utility as an adjunct imaging technique.
研究不足
Lack of a formal reference standard for correct delineation, leading to reliance on expert agreement (AND/OR scores). Potential researcher bias due to pre-existing preferences among experts. Exclusion of images due to poor quality or lack of similarity may introduce selection bias. High expertise of assessors may not generalize to less-experienced endoscopists. Real-time endoscopy challenges not fully captured by static images.
1:Experimental Design and Method Selection:
A multicenter prospective cohort study with two phases: image collection and expert assessment using an online scoring module. The study involved comparing WLE and BLI images in overview and magnification views to assess visualization and delineation of lesions.
2:Sample Selection and Data Sources:
Images from 40 Barrett's esophagus lesions were prospectively collected from patients referred for endoscopic work-up of high-grade dysplasia or esophageal adenocarcinoma. Images were obtained using the ELUXEO 7000 endoscopy system.
3:List of Experimental Equipment and Materials:
ELUXEO 7000 endoscopy system (FUJIFILM), transparent cap for endoscope, high-definition monitor, proprietary online scoring and delineation module (Meducati AB).
4:Experimental Procedures and Operational Workflow:
Endoscopic procedures performed by expert endoscopists. Images captured in WLE and BLI modes in overview and magnification. Experts assessed images in three randomized assessments with washout periods: WLE only, BLI only, and WLE+BLI side-by-side. Delineations and scores recorded using the online module.
5:Data Analysis Methods:
Statistical analysis with SPSS 24. Paired t-tests, Wilcoxon signed rank tests, McNemar tests, and Spearman's rank correlation used to compare VAS scores, ordinal scores, and AND/OR ratios.
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