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Diagnostic and Therapeutic Endoscopy
Volume 2013 (2013), Article ID 580526, 6 pages
http://dx.doi.org/10.1155/2013/580526
Research Article

Narrow Band Imaging with Magnification Endoscopy for Celiac Disease: Results from a Prospective, Single-Center Study

1Gastroenterology and Digestive Endoscopy Unit, “San Salvatore” Hospital, Piazzale Cinelli, 1-61121 Pesaro, Italy
2Department of Clinical Medicine, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
3Department of SUAN, University of Urbino, Via Ca le Suore 2/4, 61029 Urbino, Italy

Received 24 June 2013; Accepted 6 July 2013

Academic Editor: Lars Aabakken

Copyright © 2013 L. De Luca et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In celiac disease (CD), the intestinal lesions can be patchy and partial villous atrophy may elude detection at standard endoscopy (SE). Narrow Band Imaging (NBI) system in combination with a magnifying endoscope (ME) is a simple tool able to obtain targeted biopsy specimens. The aim of the study was to assess the correlation between NBI-ME and histology in CD diagnosis and to compare diagnostic accuracy between NBI-ME and SE in detecting villous abnormalities in CD. Forty-four consecutive patients with suspected CD undergoing upper gastrointestinal endoscopy have been prospectively evaluated. Utilizing both SE and NBI-ME, observed surface patterns were compared with histological results obtained from biopsy specimens using the k-Cohen agreement coefficient. NBI-ME identified partial villous atrophy in 12 patients in whom SE was normal, with sensitivity, specificity, and accuracy of 100%, 92.6%, and 95%, respectively. The overall agreement between NBI-ME and histology was significantly higher when compared with SE and histology (kappa score: 0.90 versus 0.46; ) in diagnosing CD. NBI-ME could help identify partial mucosal atrophy in the routine endoscopic practice, potentially reducing the need for blind biopsies. NBI-ME was superior to SE and can reliably predict in vivo the villous changes of CD.