BLI for the Diagnosis of Precancerous Conditions

Introduction: Traditionally, White Light Endoscopy (WLE), enhanced by biopsies following the updated Sydney system guidelines, has been the benchmark for diagnosing and classifying gastric preneoplastic conditions. Nevertheless, the pronounced interobserver variability and the often weak correlation between endoscopic observations and histopathological results have driven the increasing adoption of virtual chromoendoscopy (VCE). VCE technologies have demonstrated greater effectiveness in identifying these conditions compared to WLE, with Narrow Band Imaging (NBI) being particularly notable. Significantly, NBI has played a key role in validating the Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) system. However, data on the effectiveness of other VCE technologies in this domain is relatively sparse in Europe, specifically with Blue Light Imaging (BLI), despite the promising diagnostic performance demonstrated with this technology.

Primary aim: to assess the diagnostic accuracy of BLI and to externally validate the applicability of EGGIM classification for staging GIM.

Material and methods: a multicentric cohort study will be performed involving centres from two European countries (Portugal, Italy). Consecutive patients performing upper gastrointestinal endoscopy will be evaluated by WLE and BLI. Random biopsies or targeted plus random biopsies will be performed in order to determine de accuracy of BLI system to detect and stage GIM.

Expected results: We anticipate that BLI would enable us to assess the extension of GIM without the need for biopsies. If observed, this would overall improve the upper GI endoscopy accuracy.

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Key information

Conditions

Gastric Cancer Digestive System Diseases Digestive System Neoplasms Early Gastric Cancer Gastrointestinal Diseases Gastrointestinal Neoplasms Neoplasms Neoplasms by Site Precancerous Conditions Preneoplastic Condition Stomach Diseases Stomach Neoplasms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Marta Rodriguez

Porto, Portugal

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Individuals older than 18 years.
Indication to submit diagnostic or surveillance upper GI endoscopy.

Exclusion criteria

History of previous gastric surgery.
History of previous gastric cancer.
Contraindications to biopsies.
Individuals unable to give informed consent

Treatment and study plan

Primary outcomes

To determine the inter-observer agreement and accuracy of BLI system for the diagnosis and endoscopic staging of GIM

Time frame: During the 3 months after finishing histopathological analysis of biopsies (an average of 17 months)

For accuracy: A per-biopsy analysis will be performed comparing diagnostic perception per site biopsied (ie, accuracy of WLE or BLI for each site observed vs that result).

For inter-observer agreement: after following educational set, inter-observer agreement for WLE and BLI will be assessed (see phase 2).
To externally validate the EGGIM score classification using BLI

Time frame: During the 12 months after finishing histopathological analysis of biopsies (an average of 17 months)

For accuracy: A per-patient analysis will be performed comparing WLE and BLI accuracy for Operative Link on Gastritis Assessment for Intestinal Metaplasia (OLGIM) III/IV (ie, accuracy of EGGIM estimated by each endoscopist using WLE or BLI towards OLGIM III/IV).

For inter-observer agreement: after completion phase 3, video records will be assessed by 1 endoscopist and inter-observer agreement for EGGIM classification, using BLI system, will be evaluated

Sponsors and collaborators

Lead sponsor

Instituto Portugues de Oncologia, Francisco Gentil, Porto

Other

Registry information

Official study title

Blue Light Imaging System for the Diagnosis of Precancerous Conditions: European Multicenter Validation Study

Important dates

Study start: 2021
Primary completion: 2023
Study completion: 2023
First posted: Feb 24, 2021
Registry last updated: Mar 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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