Advanced Imaging for Characterization of Intestinal Metaplasia

AbstractGastric intestinal metaplasia is clinically relevant because of its role in the process of gastric carcinogenesis. The current gold standard for the diagnosis of intestinal metaplasia is histology. It may be recognized on standard white-light endoscopy as whitish plaques, and a villous appearance may even be evident with high-definition white-light endoscopy without magnification. However, standard white-light endoscopy is generally suboptimal for endoscopic diagnosis because intestinal metaplasia usually appears in flat mucosa and shows few morphological changes. Techniques of image-enhanced endoscopy, especially in the setting of magnifying endoscopy with high definition, are useful in the detection of such lesions and will permit targeted biopsies. This video review will demonstrate the typical appearance of intestinal metaplasia on white-light endoscopy, with methylene blue chromoendoscopy and narrow-band imaging. This article is part of an expert video encyclopedia