Narrow-band imaging with magnifying endoscopy for theevaluation of gastrointestinal lesions

Narrow band imaging （NBI） endoscopy is an opticalimage enhancing technology that allows a detailedinspection of vascular and mucosal patterns, providingthe ability to predict histology during real-time endoscopy.By combining NBI with magnification endoscopy（NBI-ME）, the accurate assessment of lesionsin the gastrointestinal tract can be achieved, as wellas the early detection of neoplasia by emphasizingneovascularization. Promising results of the method inthe diagnosis of premalignant and malignant lesionsof gastrointestinal tract have been reported in clinicalstudies. The usefulness of NBI-ME as an adjunct toendoscopic therapy in clinical practice, the potentialto improve diagnostic accuracy, surveillance strategiesand cost-saving strategies based on this method aresummarized in this review. Various classification systemsof mucosal and vascular patterns used to differentiatepreneoplastic and neoplastic lesions have beenreviewed. We concluded that the clinical applicabilityof NBI-ME has increased, but standardization ofendoscopic criteria and classification systems, validationin randomized multicenter trials and training programsto improve the diagnostic performance are all neededbefore the widespread acceptance of the method inroutine practice. However, published data regarding theusefulness of NBI endoscopy are relevant in order torecommend the method as a reliable tool in diagnosticand therapy, even for less experienced endoscopists.