Explore how NBI and Dual Focus can effectively reduce biopsies.
Why are biopsies taken?
Biopsies are important to histologically assess tissue of suspicious lesions and differentiate malignant, inflammatory, or infectious conditions.
What issues exist with biopsies?
Biopsies are only small interventions bearing a minimum risk for the patient (1), but this may differ for patients medicated with anticoagulants. (1) Taken together, biopsies are valuable for risk stratification with very low complication ratios. Their biggest drawback is cost for the histological examination.
According to current guidelines, biopsies are randomly taken in Barrett’s Esophagus surveillance, stomach, and CRC high-risk patients (e.g. IBD). (2,3,4) Most of these biopsies do not contain dysplastic tissue, since they are not targeted, leading to high costs with moderate detection capability, warranting a more efficient modality. (5,6)
How can Olympus technology help to reduce biopsies?
NBI has been vastly studied to assess its capability to detect and diagnose gastrointestinal lesions:
The diagnostic accuracy of NBI for colorectal lesions has been shown to be >90% (7,8,9). Dual Focus raised the ratio of high-confidence decisions. (9) Thus, NBI with Dual Focus may help to reduce the need to biopsy lesions prior to treatment.
NBI proved to be a reliable modality for targeted biopsy in Barrett’s Esophagus – identifying more neoplasia but using significantly less biopsies. (10,11) Although, biopsy cannot be avoided completely, NBI may thus improve quality and cost-effectiveness of Barrett’s Esophagus surveillance.
European and American gestroenterology societies endorsed the use of NBI for optical diagnosis of colorectal polyps (ESGE, ASGE)(25,27) and targeted biopsy in Barrett's Esophagus surveillance (ASGE).(47)
Also for other gastrointestinal indications, NBI targeted biopsy is investigated and seems to be a promising tool to improve clinical outcomes. (12,13)