The Efficacy of Virtual Chromoendoscopy in the Diagnosis of Portal Hypertensive Gastropathy
Background: Diagnosis of portal hypertensive gastropathy (PHG) is based on endoscopic criteria. I-scan technology, a new technique of virtual chromoendoscopy, increases the diagnostic accuracy for lesions in the gastrointestinal tract. Aim: To establish the role of i-scan endoscopy in the diagnosis of PHG.
Method: In this prospective study, endoscopic examination was conducted first by using white light and after that i-scan 1 and i-scan 2 technology in a group of 50 consecutive cirrhotic patients. The endoscopic diagnostic criteria for PHG followed the Baveno criteria. The interobserver agreement between white light endoscopy and i-scan endoscopy was determined using Cohen’s kappa statistics.
Results: Forty-five of the 50 patients met the diagnostic criteria for PHG when examined by i-scan endoscopy and 39 patients were diagnosed with PHG by white light endoscopy. The strength of agreement between the two methods for the diagnosis of PHG was moderate (k=0.565; 95%CI 0.271-0.859; p<0.001). I-scan 1 classified the mosaic pattern better than classic endoscopy; i-scan 2 described better the red spots.
Conclusion: I-scan examination increased the diagnostic sensitivity of PHG. The diagnostic criteria (mosaic pattern and red spots) were easier to observe endoscopically using i-scan than in white light.
Abbreviations: FICE: Fuji Intelligent chromoendoscopy; GAVE: gastric antral vascular ectasia; NBI: narrow band imaging; PHG: portal hypertensive gastropathy; PHT: portal hypertension; UGIB: upper gastrointestinal bleeding.