Endoscopic visible light spectroscopy: a new, minimally invasive technique to diagnose chronic GI ischemia - 11/08/11
Reprint requests: Désirée van Noord, MD, Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The NetherlandsRiassunto |
Background |
The diagnosis of chronic GI ischemia (CGI) remains a clinical challenge. Currently, there is no single simple test with high sensitivity available. Visible light spectroscopy (VLS) is a new technique that noninvasively measures mucosal oxygen saturation during endoscopy.
Objective |
To determine the diagnostic accuracy of VLS for the detection of ischemia in a large cohort of patients.
Design |
Prospective study, with adherence to the Standards for Reporting of Diagnostic Accuracy.
Setting |
Tertiary referral center.
Patients |
Consecutive patients referred for evaluation of possible CGI.
Interventions |
Patients underwent VLS along with the standard workup consisting of evaluation of symptoms, GI tonometry, and abdominal CT or magnetic resonance angiography.
Main Outcome Measurements |
VLS measurements and the diagnosis of CGI as established with the standard workup.
Results |
In 16 months, 121 patients were included: 80 in a training data set and 41 patients in a validation data set. CGI was diagnosed in 89 patients (74%). VLS cutoff values were determined based on the diagnosis of CGI and applied in the validation data set, and the results were compared with the criterion standard, resulting in a sensitivity and specificity of VLS of 90% and 60%, respectively. Repeated VLS measurements showed improvement in 80% of CGI patients after successful treatment.
Limitations |
Single-center study; only 43% of patients had repeated VLS measurements after treatment.
Conclusions |
VLS during upper endoscopy is a promising easy-to-perform and minimally invasive technique to detect mucosal hypoxemia in patients clinically suspected of having CGI, showing excellent correlation with the established ischemia workup.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : CGI, NOMI, TM, VLS
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| DISCLOSURE: The following author disclosed a financial relationship relevant to this publication: Dr. Benaron: Founder of Spectros with more than 5% equity stake. All other authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact Dr. van Noord at d.vannoord@erasmusmc.nl. |
Vol 73 - N° 2
P. 291-298 - febbraio 2011 Ritorno al numero
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