What type of study is this?

This is a Meta-Analysis study (also classified as: Systematic Review).

What question did this study set out to answer?

To synthesize evidence on the effectiveness of narrow band imaging in Barrett’s oesophagus surveillance.

March 15, 2026Open Access

Advanced imaging (narrow band and acetic acid chromoendoscopy) and guided biopsies in surveillance of Barrett’s oesophagus: a systematic review

Key Points

To synthesize evidence on the effectiveness of narrow band imaging in Barrett’s oesophagus surveillance.
Conducted a systematic review following Joanna Briggs Institute guidelines.
Included interventional and cohort studies on the effectiveness of narrow band imaging.
Performed database searches across major biomedical literature databases up to January 2025.
Identified 44 articles meeting inclusion criteria after initial searches included 974 entries.
Narrow band imaging improved dysplasia detection compared to traditional methods.
Both narrow band imaging and acetic acid chromoendoscopy were effective, but neither replaced Seattle protocol.

Abstract

Objectives To systematically synthesise the evidence behind the use of narrow band imaging (NBI) and acetic acid chromoendoscopy (AAC) in Barrett’s oesophagus (BO) surveillance. Design The exploration phase followed the conceptual frameworks of Arksey and O’Malley and Levac et al for scoping reviews, and subsequently evolved into a systematic review that followed Joanna Briggs Institute (JBI) methodological guidance for conduct and Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for reporting. Data sources PubMed, Medline, Scopus, Web of Science, Embase, CINHAL, Gray literature (GreyNet and OpenGrey) and reference reading. Eligibility criteria Peer-reviewed full publications on interventional studies and cohort studies reporting effectiveness of NBI or AAC used for BO surveillance were included. Database searches were performed without restrictions on date of publication, up to the search period (December 2024–January 2025). Other observational studies, abstracts and non-English publications were excluded. Data extraction and synthesis Data extraction and synthesis was performed by two reviewers using Covidence. The data were synthesised narratively and evaluated for quality of evidence. Results Initial search produced 974 articles. After excluding duplicates (389), ineligible articles (526) and abstract-only publications (15), 44 articles were selected for inclusion. Results indicated that NBI-targeted biopsies are more effective in overall dysplasia detection than white light endoscopy (WLE). While NBI and AAC are both effective in BO diagnosis with a smaller number of biopsies, AAC demonstrated a higher sensitivity for neoplasia detection than WLE. However, neither NBI-guided nor AAC-guided biopsy was able to replace Seattle protocol. Conclusion NBI provides higher dysplasia detection and AAC has a higher sensitivity, but neither can safely replace Seattle protocol biopsies.

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