Comparison of white-light endoscopy, optical-enhanced and acetic-acid magnifying endoscopy for detecting gastric intestinal metaplasia: A randomized trial

Figure 1 Endoscopic images in the magnifying mode. A and B: In the optical-enhanced endoscopy Mode 1 and magnifying endoscopy image, light blue crest appears as blue-white lines visible on the epithelial surface; C and D: After spraying acetic acid, villous or cerebral gyrus-like structure, partial pits missing, and irregular arrangement are usually shown in magnifying mode.

Figure 2 Flow chart of the examinations: 180 patients enrolled, 156 patients eligible for white-light endoscopy (24 patients excluded: 4 with gastrointestinal hemorrhage, 5 with gastrectomy, 14 with coagulopathy, and one patient with advanced gastric cancer). WLE: White-light endoscopy; ME-AAC: Acetic-acid chromoendoscopy combined with magnifying endoscopy.

Figure 3 Appearance of gastric intestinal metaplasia under three different endoscopic methods. A and D: Lesions as ash-colored nodular changes (white-light endoscopy); B and E: Bluish-whitish lesion area (optical-enhanced endoscopy, Mode 1); C and F: The clearer, whitish patches observed after spraying with acetic acid (acetic-acid chromoendoscopy).

Figure 4 The time required for optical-enhanced magnifying endoscopy and acetic-acid chromoendoscopy combined with magnifying endoscopy to diagnose gastric intestinal metaplasia. Fold change was calculated by dividing the time required for optical-enhanced magnifying endoscopy by the time required for acetic-acid chromoendoscopy combined with magnifying endoscopy. ME-OE: Optical-enhanced magnifying endoscopy; ME-AAC: Acetic-acid chromoendoscopy combined with magnifying endoscopy.