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Narrow-band imaging (NBI) improves visualization of mucosa and vasculature, but its superiority to white-light imaging (WLI) in high-risk patients is unclear. This systematic review and meta-analysis of randomized controlled trials compared NBI versus WLI in gastroscopy for cancer surveillance or red-flag symptoms using PROSPERO registration, PRISMA 2020 methods, and risk-of-bias and GRADE certainty assessments. Three RCTs (6003 patients) showed no significant increase in overall gastric neoplasm detection with NBI (2.79% vs 2.74%; RR 0.98). Focal lesion detection and positive predictive value were also not significantly different, with overall low certainty. 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The review reported high risk of bias for blinding and low overall certainty of evidence, and concluded that larger multicenter RCTs are needed.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},368860,1790231699,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Systematic Review  \nNarrow-Band Imaging for the Detection of Early Gastric Cancer Among High-Risk Patients: A Systematic Review and Meta-Analysis  \nMagdalini Manti 1, Paraskevas Gkolfakis 2, *, Nikolaos Kamperidis 1, Alexandros Toskas 1, Apostolis Papaefthymiou 3, Georgios Tziatzios 4, Ravi Misra 1 and Naila Arebi 1  \nAcademic Editor: Almantas Maleckas  \nReceived: 3 August 2025  \nRevised: 3 September 2025  \nAccepted: 5 September 2025  \nPublished: 6 September 2025  \nCitation: Manti, M.; Gkolfakis, P.; Kamperidis, N.; Toskas, A.;  \nPapaefthymiou, A.; Tziatzios, G.; Misra, R.; Arebi, N. Narrow-Band Imaging for the Detection of Early Gastric Cancer Among High-Risk Patients: A Systematic Review and Meta-Analysis. Medicina 2025, 61, 1613 . [https://doi.org/10.3390/medicina](https://doi.org/10.3390/medicina)[ ](https://doi.org/10.3390/medicina)61091613  \nCopyright: © 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) .  \n1 Gastroenterology Unit, St Mark’s Hospital, Acton Ln, London NW10 7NS, UK;  \n[manti.magdalini@gmail.com](manti.magdalini@gmail.com) (M.M.); [nkamperidis@nhs.net](nkamperidis@nhs.net) (N.K.); [a.toskas@nhs.net](a.toskas@nhs.net) (A.T.);  \n[rmisra@nhs.net](rmisra@nhs.net) (R.M.); [naila.arebi@imperial.ac.uk](naila.arebi@imperial.ac.uk) (N.A.)  \n2 Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic, Attikon University Hospital, Rimini 1, Chaidari, 12462 Athens, Greece  \n3 Department of Gastroenterology, General University Hospital of Larissa, 41334 Larissa, Greece; [appapaef@hotmail.com](appapaef@hotmail.com)  \n4 Department of Gastroenterology,“Konstantopoulio-Patision” General Hospital of Nea Ionia,  \n14233 Athens, Greece  \n* [Correspondence: pgolfakis@gmail.com](Correspondence: pgolfakis@gmail.com)  \nAbstract  \nBackground and Objectives: Early gastric cancer (EGC) has an excellent prognosis when detected, yet miss rates during endoscopy remain high. Narrow-band imaging (NBI) enhances mucosal and vascular visualization and is increasingly used, but its benefit over white-light imaging (WLI) in high-risk patients is uncertain. This study aimed to compare NBI with WLI for the detection of gastric neoplasia in patients undergoing gastroscopy. Materials and Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), registered in PROSPERO (CRD42025649908) and reported according to PRISMA 2020 guidelines. PubMed, Scopus, and CENTRAL were searched up to October 2024 . Eligible RCTs randomized adults undergoing gastroscopy for cancer surveillance or red-flag symptoms to NBI or WLI. Data extraction and risk of bias assessment were performed independently by two reviewers. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model, and certainty of evidence was graded with GRADE. Results: From 21 records, 3 RCTs comprising 6003 patients were included. NBI did not significantly increase gastric neoplasm detection compared with WLI (2.79% vs. 2.74%; RR = 0.98; 95% CI: 0.66–1.45; I2 = 22%) . Focal gastric lesion detection rates (14 .73% vs. 15.50%; RR = 1 .05; 95% CI: 0 .72–1.52; I2 = 87%) and positive predictive value (29.56% vs. 20.56%; RR = 1.29; 95% CI: 0.84–1.99; I2 = 61%) also showed no significant differences. Risk of bias was high for blinding, and overall evidence certainty was low. In practical terms, both NBI and WLI detected gastric cancers at similar rates, indicating that while NBI enhances visualization, it does not increase the likelihood of finding additional cancers in high-risk patients. Conclusions: NBI did not significantly improve gastric neoplasm de","cbCaiggo4B1I6VvM","https://ap.wps.com/l/cbCaiggo4B1I6VvM","pdf",1942781,17,"English","# Abstract\n# Introduction\n# Background on gastric cancer and early detection\n# Imaging approaches: WLI and magnifying endoscopy\n# Aim and study design\n# Results\n## Overall detection outcomes","[{\"question\":\"What is the primary objective of the review?\",\"answer\":\"To compare narrow-band imaging (NBI) with white-light imaging (WLI) for detecting gastric neoplasia during gastroscopy in high-risk patients.\"},{\"question\":\"What evidence was included in the meta-analysis?\",\"answer\":\"Randomized controlled trials enrolling adults undergoing gastroscopy for cancer surveillance or red-flag symptoms, searched across PubMed, Scopus, and CENTRAL up to October 2024; 3 RCTs with 6003 patients were included.\"},{\"question\":\"Did NBI improve gastric neoplasm detection compared with WLI?\",\"answer\":\"No. NBI did not significantly increase overall gastric neoplasm detection versus WLI (RR 0.98; 95% CI 0.66–1.45).\"},{\"question\":\"What were the review’s practical implications and limitations?\",\"answer\":\"Both modalities detected gastric cancers at similar rates; NBI remained valuable for mucosal and vascular assessment. The review reported high risk of bias for blinding and low overall certainty of evidence, and concluded that larger multicenter RCTs are needed.\"}]","Narrow-Band Imaging for the Detection of Early Gastric Cancer Among High-Risk Patients - A Systematic Review and Meta-Analysis | PDF",1790178962,43]