Classifies Barrett mucosa on NBI as regular or irregular mucosal and vascular patterns to predict NDBE versus HGD/EAC. Both regular → NDBE; either irregular → HGD/EAC. High-confidence reads are more accurate.
Classification overview
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Mucosal pattern
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Mucosa regular · Circular, ridged/villous, or tubular
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Mucosa irregular · Absent or irregular
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Vascular pattern
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Vessels regular · Regular vessels along or between ridges
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Vessels irregular · Absent or irregular vessels
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Predicted histology
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NDBE · Both patterns regular
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HGD/EAC · Either pattern irregular
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Assessment
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Confidence · High vs low
Mucosal pattern
Mucosa regular
Circular, ridged/villous, or tubular
Pattern
Circular, ridged/villous, or tubular mucosal pattern
Mucosa irregular
Absent or irregular
Pattern
Absent or irregular mucosal pattern
Vascular pattern
Vessels regular
Regular vessels along or between ridges
Pattern
Blood vessels regularly situated along or between mucosal ridges
Vessels irregular
Absent or irregular vessels
Pattern
Absent or irregularly distributed vessels
Predicted histology
NDBE
Both patterns regular
Rule
Regular mucosa and regular vessels predict nondysplastic Barrett’s esophagus
HGD/EAC
Either pattern irregular
Rule
Irregular mucosa or irregular vessels predict high-grade dysplasia or esophageal adenocarcinoma
Note: Either irregular mucosa or irregular vessels predicts HGD/EAC.
Assessment
Confidence
High vs low
High
High-confidence assessments were more accurate (about 92% in Sharma 2016) than low-confidence assessments
Use
Target irregular areas for biopsy or resection. BING does not replace Prague length or the Japanese Barrett definition
Do not enter identifiable patient information or patient images.
Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.