Pay attention to the application of indocyanine green fluorescence imaging technology in laparoscopic liver cancer resection

Traditional laparoscopic liver cancer resection faces challenges,such as difficultiesin tumor localization and accurate marking of liver segments,as well as theinability to provide real-time intraoperative navigation.This approach falls shortof meeting the demands for precise and anatomical liver resection.The introductionof fluorescence imaging technology,particularly indocyanine green,hasdemonstrated significant advantages in visualizing bile ducts,tumor localization,segment staining,microscopic lesion display,margin examination,and lymphnode visualization.This technology addresses the inherent limitations oftraditional laparoscopy,which lacks direct tactile feedback,and is increasinglybecoming the standard in laparoscopic procedures.Guided by fluorescenceimaging technology,laparoscopic liver cancer resection is poised to become thepredominant technique for liver tumor removal,enhancing the accuracy,safetyand efficiency of the procedure.

The Application Progress of Skin Imaging Technology in Psoriasis

Skin imaging technologies such as dermoscopy, high-frequency ultrasound, reflective confocal microscopy and optical coherence tomography are developing rapidly in clinical application. Skin imaging technology can improve clinical diagnosis rate, and its non-invasiveness and repeatability make it occupy an irreplaceable position in clinical diagnosis. With the “booming development” of medical technology, skin imaging technology can improve clinical diagnosis rate. Researchers have made significant advances in assisting clinical diagnosis, prediction, and treatment of disease. This article reviews the application and progress of skin imaging in the diagnosis of psoriasis.

A new horizon for neuroscience:terahertz biotechnology in brain research

Terahertz biotechnology has been increasingly applied in various biomedical fields and has especially shown great potential for application in brain sciences.In this article,we review the development of terahertz biotechnology and its applications in the field of neuropsychiatry.Available evidence indicates promising prospects for the use of terahertz spectroscopy and terahertz imaging techniques in the diagnosis of amyloid disease,cerebrovascular disease,glioma,psychiatric disease,traumatic brain injury,and myelin deficit.In vitro and animal experiments have also demonstrated the potential therapeutic value of terahertz technology in some neuropsychiatric diseases.Although the precise underlying mechanism of the interactions between terahertz electromagnetic waves and the biosystem is not yet fully understood,the research progress in this field shows great potential for biomedical noninvasive diagnostic and therapeutic applications.However,the biosafety of terahertz radiation requires further exploration regarding its two-sided efficacy in practical applications.This review demonstrates that terahertz biotechnology has the potential to be a promising method in the field of neuropsychiatry based on its unique advantages.

Diagnostic value of upper gastrointestinal imaging for duodenal webbing in adults:A case report

BACKGROUND Duodenal web is a rare congenital malformation,exceedingly uncommon in adults,and often misdiagnosed due to the subtle imaging features.CASE SUMMARY By analyzing the clinical diagnosis process and various imaging findings of a patient from our institution,this case report emphasizes the necessity of upper gastrointestinal series in diagnosing duodenal webs,outlines its typical radiographic features,and provides a literature review on the etiology,clinical presentation,and management of this condition.CONCLUSION This case report emphasizes the necessity of upper gastrointestinal series in diagnosing duodenal webs.

Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial

Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

Could near focus endoscopy,narrow-band imaging,and acetic acid improve the visualization of microscopic features of stomach mucosa?

BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.

Enhancing transjugular intrahepatic portosystemic shunt procedure efficiency with digital subtraction angiography image overlay technology in esophagogastric variceal bleeding

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.AIM To evaluate the efficacy of digital subtraction angiography image overlay tech-nology(DIT)in guiding the TIPS procedure.METHODS We conducted a retrospective analysis of patients who underwent TIPS at our hospital,comparing outcomes between an ultrasound-guided group and a DIT-guided group.Our analysis focused on the duration of the portosystemic shunt puncture,the number of punctures needed,the total surgical time,and various clinical indicators related to the surgery.RESULTS The study included 52 patients with esophagogastric varices due to chronic hepatic schistosomiasis.Results demonstrated that the DIT-guided group expe-rienced significantly shorter puncture times(P<0.001)and surgical durations(P=0.022)compared to the ultrasound-guided group.Additionally,postoperative assessments showed significant reductions in aspartate aminotransferase,B-type natriuretic peptide,and portal vein pressure in both groups.Notably,the DIT-guided group also showed significant reductions in total bilirubin(P=0.001)and alanine aminotransferase(P=0.023).CONCLUSION The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistoso-miasis.

A Comprehensive Study on the digestive Endoscopic Technique and Narrow-Band Imaging for Early Gastric Cancer Screening

Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.

Acute pancreatitis:A review of diagnosis,severity prediction and prognosis assessment from imaging technology,scoring system and artificial intelligence

Acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of AP typically involve the use of imaging technologies,such as computed tomography,magnetic resonance imaging,and ultrasound,and scoring systems,including Ranson,Acute Physiology and Chronic Health Evaluation II,and Bedside Index for Severity in AP scores.Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity,while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications.Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild,moderate,or severe categories,guiding treatment decisions,such as intensive care unit admission,early enteral feeding,and antibiotic use.Despite the central role of imaging technologies and scoring systems in AP management,these methods have limitations in terms of accuracy,reproducibility,practicality and economics.Recent advancements of artificial intelligence(AI)provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data.AI algorithms can analyze large amounts of clinical and imaging data,identify scoring system patterns,and predict the clinical course of disease.AI-based models have shown promising results in predicting the severity and mortality of AP,but further validation and standardization are required before widespread clinical application.In addition,understanding the correlation between these three technologies will aid in developing new methods that can accurately,sensitively,and specifically be used in the diagnosis,severity prediction,and prognosis assessment of AP through complementary advantages.

Fracture evolution and localization effect of damage in rock based on wave velocity imaging technology

By utilizing wave velocity imaging technology,the uniaxial multi-stage loading test was conducted on siltstone to attain wave velocity imagings during rock fracture.Based on the time series parameters of acoustic emissions(AE),joint response characteristics of the velocity field and AE during rock fracture were analyzed.Moreover,the localization effect of damage during rock fracture was explored by applying wave velocity imagings.The experimental result showed that the wave velocity imagings enable three-dimensional(3-D)visualization of the extent and spatial position of damage to the rock.A damaged zone has a low wave velocity and a zone where the low wave velocity is concentrated tends to correspond to a severely damaged zone.AE parameters and wave velocity imagings depict the changes in activity of cracks during rock fracture from temporal and spatial perspectives,respectively:the activity of cracks is strengthened,and the rate of AE events increases during rock fracture;correspondingly,the low-velocity zones are gradually aggregated and their area gradually increases.From the wave velocity imagings,the damaged zones in rock were divided into an initially damaged zone,a progressively damaged zone,and a fractured zone.During rock fracture,the progressively damaged zone and the fractured zone both develop around the initially damaged zone,showing a typical localization effect of the damage.By capturing the spatial development trends of the progressively damaged zone and fractured zone in wave velocity imagings,the development of microfractures can be predicted,exerting practical significance for determining the position of the main fracture.

Anisotropic creep behavior of soft-hard interbedded rock masses based on 3D printing and digital imaging correlation technology

Three-dimensional(3D)printing technology is increasingly used in experimental research of geotechnical engineering.Compared to other materials,3D layer-by-layer printing specimens are extremely similar to the inherent properties of natural layered rock masses.In this paper,soft-hard interbedded rock masses with different dip angles were prepared based on 3D printing(3DP)sand core technology.Uniaxial compression creep tests were conducted to investigate its anisotropic creep behavior based on digital imaging correlation(DIC)technology.The results show that the anisotropic creep behavior of the 3DP soft-hard interbedded rock mass is mainly affected by the dip angles of the weak interlayer when the stress is at low levels.As the stress level increases,the effect of creep stress on its creep anisotropy increases significantly,and the dip angle is no longer the main factor.The minimum value of the long-term strength and creep failure strength always appears in the weak interlayer within 30°–60°,which explains why the failure of the layered rock mass is controlled by the weak interlayer and generally emerges at 45°.The tests results are verified by comparing with theoretical and other published studies.The feasibility of the 3DP soft-hard interbedded rock mass provides broad prospects and application values for 3DP technology in future experimental research.

Photodissociation Dynamics of Dichlorodifluoromethane（CF2Cl2） around 235 nm using Time-Sliced Velocity Map Imaging Technology

Photodissociation dynamics of dichlorodifluoromethane (CF2Cl2) around 235 nm has been studied using the time-sliced velocity map imaging technology in combination with the resonance enhanced multi-photon ionization technology. By measuring the raw images of chlorine atoms which are formed via one-photon dissociation of CF2Cl2, the speed and angular distributions can be directly obtained. The speed distribution of excited-state chlorine atoms consists of high translation energy (ET) and low ET components, which are related to direct dissociation on 3Q0 state and predissociation on the ground state induced by internal conversion, respectively. The speed distribution of ground-state chlorine atoms also consists of high ET and low ET components which are related to predissociation between 3Q0 and 1Q1 states and predissociation on the ground state induced by internal conversion, respectively. Radical dissociation channel is confirmed, nevertheless, secondary dissociation and three-body dissociation channels are excluded.

An analysis of the uniformity of multi-fracture initiation based on downhole video imaging technology: A case study of Mahu tight conglomerate in Junggar Basin, NW China

To solve the problem that the production of Mahu conglomerate reservoir is not up to expectation after the multi-cluster plus temporary plugging fracturing technology is applied in horizontal wells, stages 2–6 in the test well MaHW6285 are selected to carry out erosion tests with different pumping parameters. The downhole video imaging technology is used to monitor the degree of perforations erosion, and then the fracture initiation and proppant distribution of each cluster are analyzed. The results showed that proppant entered 76.7% of the perforations. The proppant was mainly distributed in a few perforation clusters, and the amount of proppant entered in most of the clusters was limited. The proppant distribution in Stage 4 was relatively uniform, and the fracture initiation of each cluster in the stage is more uniform. The proppant distribution in stages 2, 3, 5, and 6 was significantly uneven, and the uniform degree of fracture initiation in each cluster is low. More than 70% of the proppant dose in the stage entered clusters near the heel end, so the addition of diverters did not promote the uniform initiation of hydraulic fractures. There was a positive correlation between the amount of proppant added and the degree of perforations erosion, and the degree of perforations erosion ranged from 15% to 352%, with an average value of 74.5%, which was far higher than the statistical results of shale reservoir tests in North America. The use of 180° phase perforation(horizontal direction) can reduce the “Phase Bias” of perforations erosion, promote uniform perforations erosion and fluid inflow. The research results provide the basis for optimizing the pumping procedure, reducing the perforation erosion and improving the success rate of diversion.

Application Advantages of Staring Area Imaging Technology(SAIT) for Microsatellites

The Staring Area Imaging Technology(SAIT) satellite continuously "images" the target over a certain time range, and can realize continuous imaging and multi-angle imaging of the area of interest. It has the characteristics of flexible imaging parameter setting and fast image preprocessing speed, enabling dynamic target detection and tracking, super-resolution, surface 3 D model construction, night-time imaging and many other application tasks. Based on the technical characteristics of the SAIT satellite, this paper analyzes the challenges in satellite development and data processing, focuses on the quasi-realtime application of SAIT satellite data, and looks at the development trend of the SAIT satellite.

Evaluation of BSc Radiologic Sciences and Medical Imaging Technology Programmes in Sudanese Universities from Students’ Perspective

This study sets the objective to involve undergraduate students in the evaluation of radiologic sciences and medical imaging technology programmes in Sudanese universities. Based on the analysis of survey results in which the participants (BSc students undertaking radiologic sciences and medical imaging technology programmes at university level) are asked to answer both closed and open-ended questions, the study seeks to reveal the participants’ perceptions and introspections about the radiologic sciences and medical imaging technology programmes in Sudan. It also attempts to explore the participants’ suggestions and recommendations as to enhance the quality of these programmes with an eye to helping syllabus designers to improve these programmes, thereby bettering healthcare services for the larger good to the community. A brief cross-sectional survey is completed by a total of 105 radiologic sciences and medical imaging technology students, i.e. 39 (37.1%) third-year students and 66 (62.9%) fourth-year students. The majority of participants is satisfied with the programmes, indicating that they are up-to-date and ran abreast with the latest developments in the field. Very few suggest that the programmes should be reviewed for revision, implying that there is room for improvement. Some participants recommend that more training hours in modern imaging modalities (e.g. MRI, CT and U/S) should be introduced. Only one participant recommends the introduction of advanced training centres.

Application of Hyperspectral Imaging Technology in Rapid Detection of Preservative in Milk

To ensure the quality and safety of pure milk,detection method of typical preservative-potassium sorbate in milk was researched in this paper.Hyperspectral imaging technology was applied to realize rapid detection.Influence factors for hyperspectral data collection for milk samples were firstly researched,including height of sample,bottom color and sample filled up container or not.Pretreatment methods and variable selection algorithms were applied into original spectral data.Rapid detection models were built based on support vector machine method(SVM).Finally,standard normalized variable(SNV)-competitive adaptive reweighted sampling(CARS)and SVM model was chosen in this paper.The accuracies of calibration set and testing set were 0.97 and 0.97,respectively.Kappa coefficient of the model was 0.93.It could be seen that hyperspectral imaging technology could be used to detect for potassium sorbate in milk.Meanwhile,it also provided methodological supports for the rapid detection of other preservatives in milk.

Narrow-band imaging optical chromocolonoscopy: Advantages and limitations

Narrow-band imaging （NBI） is an innovative optical technology that modifies the center wavelength and bandwidth of an endoscope＇s light into narrow-band illumination of 415 ：1： 30 nm. NBI markedly improves capillary pattern contrast and is an in vivo method for visualizing microvessel morphological changes in superficial neoplastic lesions. The scientific basis for NBI is that short wavelength light falls within the hemoglobin absorption band, thereby facilitating clearer visualization of vascular structures. Several studies have reported advantages and limitations of NBI colonoscopy in the colorectum. One difficulty in evaluating results, however, has been nonstandardization of NBI systems （Sequential and nonsequential）. Utilization of NBI technology has been increasing worldwide, but accurate pit pattern analysis and sufficient skill in magnifying colonoscopy are basic fundamentals required for proficiency in NBI diagnosis of colorectal lesions. Modern optical technology without proper image interpretation wastes resources, confuses untrained endoscopists and delays interinstitutional validation studies. Training in the principles of ＂optical image-enhanced endoscopy＂ is needed to close the gap between technological advancements and their clinical usefulness. Currently available evidence indicates that NBI constitutes an effective and reliable alternative to chromocolonoscopy for in vivo visualization of vascular structures, but further study assessing reproducibility and effectiveness in the colorectum is ongoing at various medical centers.

Diagnostic performance of magnifying narrow-band imaging for early gastric cancer: A meta-analysis

AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging(ME-NBI) in the diagnosis of early gastric cancer(EGC).METHODS: Systematic literature searches were conducted until February 2014 in Pub Med, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic(ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks' asymmetry test was used to evaluate the publication bias.RESULTS: Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86(95%CI: 0.83-0.89), 0.96(95%CI: 0.95-0.97) and 102.75(95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivityof 0.57(95%CI: 0.50-0.64) and a specificity of 0.79(95%CI: 0.76-0.81). When using "VS"(vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64(95%CI: 0.52-0.75) and 0.96(95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74(95%CI: 0.65-0.82) and 0.98(95%CI: 0.97-0.98).CONCLUSION: ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.

Magnifying narrow-band imaging endoscopy is superior in diagnosis of early gastric cancer

AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.

Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia

AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. METHODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME examination overlooked GIM in 8 cases, but the GIM was less than 5% in 7 of the cases. Moreover, in the 6 false positive cases, the histological examination showed the presence of reactive gastropathy (4 cases) or H. pylori active chronic gastritis (2 cases). The semiquantitative correlation between the rate of LBC appearance and the percentage of GIM was 79% (P < 0.01). CONCLUSION:NBI-ME achieved good sensitivity and specificity in recognising GIM in an unselected population. In routine clinical practice, this technique can reliably target gastric biopsies.