Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Tinelli, Andrea; Surico, Daniela; Leo, Livio; Pinto, Vincenzo; Surico, N; Fusco, Annarita; Cicinelli, Maria Vittoria; Meir, Y. J.; Cicinelli, Ettore

doi:10.1097/gme.0b013e31821221cd

Cited by 19 publications

(20 citation statements)

References 11 publications

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“…We believe that it is important to determine the extent by which NBI diagnostic accuracy depends on surgeon experience, and accuracy can be improved by learning. Like other studies, our study demonstrated that significant improvement in the diagnostic accuracy of NBI was possible after training [11][12][13]. The kappa values of inter-observer agreement were better for NBI than were seen for WLH after training of those students who had some hysteroscopy experience prior to training.…”

Section: Discussionsupporting

confidence: 79%

Prospective Evaluation of the Accuracy of A Training Program in Image Recognition by Narrow-Band Imaging Guided Hysteroscopy of Endometrial Neoplasms

Wang

Chen

Kong

et al. 2020

Gynecol Obstet Invest

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Introduction: Narrow-band imaging (NBI) hysteroscopy by experienced hysteroscopists (EH) is useful for diagnosing endometrial neoplasms. Objective: We investigated whether the diagnostic reliability of NBI could be improved by specific professional training. Methods: Three levels of trainees who were Surgeons at our hospital were selected. Level I: 6 trainees had no prior hysteroscopic experience; level II: 6 trainees had experience with <100 cases; and level III: 6 trainees had <500 cases. The two-hour training program for white light hysteroscopy (WLH) and NBI included information on the classifications of diseases of the uterine cavity and on the features of diagnostic images. Images from 529 patients were evaluated independently by trainees with 3 levels of before and after training, and by EH. Trainees and EHs had to analyze and arrive at a hysteroscopic diagnosis for each image that was compared to the pathological diagnosis for diagnostic accuracy. Results: After training, all levels achieved higher diagnostic accuracy with NBI than was seen with WLH. Level III trainees achieved diagnostic accuracy and kappa values for NBI that were equivalent to those of EH. Conclusions: Training can increase the diagnostic skill of all trainees using NBI, especially for trainees with prior hysteroscopic experience.

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Section: Discussionsupporting

confidence: 79%

Prospective Evaluation of the Accuracy of A Training Program in Image Recognition by Narrow-Band Imaging Guided Hysteroscopy of Endometrial Neoplasms

Wang

Chen

Kong

et al. 2020

Gynecol Obstet Invest

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“…Kisu et al (2011) found that the sensitivity of diagnosis of AEH or EC was significantly higher using white light + NBI compared to white light only, without a decline in the specificity of diagnosis. In a large-scale multicenter study, Tinelli et al (2011) found that NBI significantly improved the sensitivity (60% vs. 20%, P < 0.005) and positive predictive value (67% vs. 25%, P < 0.001) compared with white light only for diagnosis of high-risk hyperplasia, with no differences in specificity, negative predictive value, and accuracy. These reports indicate that NBI may be a useful procedure to complement a hysteroscopic examination, and NBI may become established in standard clinical practice in the near future.…”

Section: Discussionmentioning

confidence: 99%

Hysteroscopic Inspection and Total Curettage Are Insufficient for Discriminating Endometrial Cancer from Atypical Endometrial Hyperplasia

Kurosawa

Itō

Nikura

et al. 2012

Tohoku J. Exp. Med.

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Endometrial cancer (EC) is the most prevalent gynecologic malignancy in Japan. Atypical endometrial hyperplasia (AEH) is viewed as the premalignant lesion of EC, however it is often difficult to distinguish EC from AEH. The rate of concurrent EC in women diagnosed preoperatively with AEH based on endometrial biopsy was reported as 17-52%. Although hysteroscopic inspection and total curettage are considered as useful methods to make diagnosis of endometrial lesions, there is no report using this combined method to discriminate EC from AEH. The purpose of this study was to examine whether hysteroscopic inspection and total curettage improve the prevalence of EC among women diagnosed preoperatively with AEH. We reviewed 22 patients who underwent hysteroscopic inspection and total curettage and were diagnosed with AEH before undergoing hysterectomy between November 2001 and May 2011. The diagnosis made with the hysterectomy specimens revealed AEH in 10 patients (45.5%), endometrial hyperplasia without atypia in 3 (13.6%), and endometrioid adenocarcinoma, the most common type of EC, in 9 (40.9%). Endometrioid adenocarcinoma included 7 patients without myometrial invasion (31.8%) and 2 patients with superficial myometrial invasion (9.1%). There was no hysteroscopic finding that was specific for EC or AEH. In conclusion, about 41% of women who underwent hysterectomy under a diagnosis of AEH were found to have coexisting adenocarcinoma, although the prevalence of EC among those women was similar to that in earlier reports with endometrial biopsy. Accordingly, we must be careful in planning the therapeutic strategy for women with a preoperative diagnosis of AEH.

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“…Since 1999, the year in which it was developed, NBI has proven to be reliable in the identification of lesions in the initial phase, otherwise not diagnosable, in different anatomic areas such as the esophagus, stomach, duodenum, colorectal tract, the bronchial tree, and urogenital tract, with percentages of sensitivity and specificity ranging from 70% to 100% and 61% to 92.3%, respectively. In these fields, classifications of various vascular patterns identified with NBI technique still exist and allow the preoperative prediction of the nature of the lesion …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: Validation of a new endoscopic clinical classification

et al. 2014

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Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Cited by 19 publications

References 11 publications

Prospective Evaluation of the Accuracy of A Training Program in Image Recognition by Narrow-Band Imaging Guided Hysteroscopy of Endometrial Neoplasms

Prospective Evaluation of the Accuracy of A Training Program in Image Recognition by Narrow-Band Imaging Guided Hysteroscopy of Endometrial Neoplasms

Hysteroscopic Inspection and Total Curettage Are Insufficient for Discriminating Endometrial Cancer from Atypical Endometrial Hyperplasia

Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: Validation of a new endoscopic clinical classification

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