Diagnostic Value Of High Definition Magnifying Endoscopy With I-scan For Helicobacter Pylori Infection

Background and aims:It has been well accepted that Helicobacter pylori (H. pylori) is associated with the development of many digestive diseases. Therefore, an accurate and timely diagnosis is essential for the treatment and prevention of the potential complications. There are mainly two methods used to detect H. pylori infection: invasive tests and noninvasive tests. Both of them have some limitations in spite of good sensitivity and specificity. The invasive tests, such as rapid urease test and histologic examination, need random biopsies, which will lead to unnecessary injury and cost. The noninvasive tests, such as urea breath test, can’t give the description of the gastric mucosa. Therefore, the diagnosis of H. pylori without biopsy during endoscopy is clinically meaningful. It has been shown that the conventional white light endoscopic features of H. pylori gastritis have a poor correlation with histopathologic findings. But with the development of endoscopic technology, magnifying endoscopy, especially new kinds of magnifying endoscopies, including high definition magnifying endoscopy, magnifying endoscopy with narrow-band imaging (NBI), etc., have shown great promise for the diagnosis of H. pylori infection, according to the gastric mucosal and vascular patterns. I-scan technology is also a newly developed image-enhanced endoscopy system. Recently, this system in combination with magnifying endoscopy has been developed that can provide clear images of the mucosal and vascular patterns. The aims of our study were to investigate the usefulness of this endoscopy for the diagnosis of H. pylori infection, and to compare the diagnostic characteristics between magnifying white light endoscopy (WLE) and magnifying i-scan.Materials and methods:The greater curvature of the gastric corpus was carefully observed using magnifying WLE and magnifying i-scan, respectively. The gastric mucosal classification and scores of the image quality were recorded. The relationship between gastric mucosal classification and final diagnosis of H. pylori was calculated.Results:A total of84patients were recruited in this study. For predicting H. pylori infection, there was no difference in diagnostic sensitivity between the two methods, but magnifying i-scan had a significantly greater accuracy and higher specificity (94.0%and93.5%, respectively) compared with magnifying WLE (84.5%and80.6%, respectively)(both P<0.05). Magnifying i-scan provided better diagnostic value and better image quality for H. pylori infection than magnifying WLE (both P<0.05).Conclusions:1. High definition magnifying i-scan could show satisfactory diagnostic value for H. pylori infection.2. High definition magnifying i-scan is superior to magnifying WLE for thereal-time prediction of H. pylori infection.3. High definition magnifying i-scan shows better image quality than magnifying WLE for H. pylori infection.