Accuracy and inter-observer agreement of the nice and kudo classifications of superficial colonic lesions: a comparative study

Cocomazzi, Francesco; Gentile, Marco; Perri, Francesco; Bossa, Fabrizio; Merla, Antonio; Antonio, Ippolito; Cubisino, Rossella; Carparelli, Sonia; Marra, Antonella; Mileti, A.; Piazzolla, Mariano; Paolillo, Rosa; Copetti, Massimiliano; Parente, Paola; Graziano, Paolo; Leo, Alfredo Di; Andriulli, Angelo

doi:10.1007/s00384-021-03897-8

Cited by 8 publications

(4 citation statements)

References 38 publications

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“…These results are mostly superior to those of previous studies that investigated the application of each type of the NICE classification [ 16 , 25 , 29 ]. There are two likely reasons for the differences in the findings between these studies and our study.…”

Section: Discussioncontrasting

confidence: 51%

“…However, most of these studies were conducted to investigate the diagnostic outcomes of optical diagnosis for differentiating between neoplastic and non-neoplastic colorectal lesions. In contrast, there has been limited research on the diagnostic performance of each type of the NICE classification, and the findings were widely discrepant between the studies; the diagnostic accuracy of the NICE type 1, 2, and 3 was in the range of 36.5–92.6%, 80.0–90.7%, and 42.1–96.8%, respectively [ 16 , 25 , 29 ]. Thus, further analyses of data obtained in a clinical setting are required to determine the clinical value of each type of the NICE classification in NBI-assisted optical diagnosis of colorectal polyp histology.…”

Section: Introductionmentioning

confidence: 99%

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Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study

et al. 2021

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Background Narrow-band imaging (NBI) highlights the surface structures and vessels of colorectal polyps and is useful for determining the polyp histology. The narrow-band imaging international colorectal endoscopic (NICE) classification is a diagnostic tool for determining colorectal polyp histology based on NBI without optical magnification. In this study, we aimed to investigate the value of each type of the NICE classification for determining colorectal polyp histology using endoscopy data accumulated in a clinical setting. Methods Endoscopy data for 534 colorectal polyps (316 patients) treated at our facility were retrospectively analyzed. First, we investigated the diagnostic performance of each type of the NICE classification for the optical diagnosis of colorectal polyp histology. The procedures were performed by experienced endoscopists using high-definition colonoscopy without optical magnification. Second, inter-observer and intra-observer agreements were assessed after providing experts and non-experts with a short lecture on the NICE classification. Using 50 fine NBI images of colorectal polyps without optical magnification, the inter-observer and intra-observer agreements between five experts and five non-experts were assessed. Results The sensitivity, specificity, and accuracy values were 86.0%, 99.6%, and 98.5% for NICE type 1 lesions; 99.2%, 85.2%, and 97.8% for NICE type 2 lesions; and 81.8%, 99.6%, and 99.3% for NICE type 3 lesions, respectively. The inter-observer and intra-observer agreements ranged from substantial to excellent for both experts and non-experts. Conclusions The NICE classification had good diagnostic ability in terms of determining the polyp histology and demonstrated a high level of reproducibility among experts and non-experts. Thus, the NICE classification is a useful clinical tool that can be used without optical magnification.

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Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study

et al. 2021

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“…The sensitivity of the JNET2b classi cation for high-grade lesions was lower in comparison with NICE 2 (56.6%), but the PPV was almost twice as high as compared to NICE 2 classi cation (57.7%). These results are consistent with ndings reported in previous studies [17,18,19].…”

Section: Discussionsupporting

confidence: 94%

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

Grega,

Kmochova,

Hejcmanova

et al. 2024

Preprint

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Aims: We assessed the diagnostic performance of the Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team classification (JNET) in predicting histological outcomes of colorectal lesions. We aimed to compare their accuracy, particularly in identifying high-grade colorectal lesions (including high-grade adenomas, intramucosal carcinomas, T1 and T2 carcinomas). Methods: This was a prospective study involving 211 patients (130 men, mean age 60 years) who underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (lesions ≥ 10 mm). Lesions were classified using both NICE and JNET criteria, and final histopathological results were used for comparison. Results: Of the 257 lesions analyzed, the NICE classification demonstrated higher accuracy, correctly classifying 93.8% of lesions compared to 77.4% with JNET. Specifically, the sensitivity and positive predictive value (PPV) of NICE 2 for high-grade lesions were 100% and 24.4%, respectively. In comparison, JNET 2B had a sensitivity of 54.5% and a PPV of 52.2% for high-grade lesions. Conclusion: The NICE classification shows higher sensitivity for high-grade colorectal lesions (HGD adenomas, intramucosal carcinomas, T1 and T2 carcinomas), whereas the JNET classification, with a positive predictive value for high-grade lesions nearly double that of NICE, is more favourable for guiding therapy decisions. Trial Registration clinicaltrials.gov identifier: NCT05929365

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“…In a recent study, 11 clinicians were asked to classify 64 colon polyps using both the NICE and Kudo pit pattern classification systems. The accuracy for both classifications was comparable (82% for NICE vs. 81% for Kudo) [34]. Another surgical study of 138 colon lesions found that of 11 lesions with invasive adenocarcinoma with submucosal invasion, four had Kudo pit pattern IV and six had Kudo pit pattern V.…”

Section: Kudo Pit Pattern Classificationmentioning

confidence: 94%

Colon polyps: updates in classification and management

Dornblaser,

Young,

Shaukat

2023

Current Opinion in Gastroenterology

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Purpose of review Colon polyps are potential precursors to colorectal cancer (CRC), which remains one of the most common causes of cancer-associated death. The proper identification and management of these colorectal polyps is an important quality measure for colonoscopy outcomes. Here, we review colon polyp epidemiology, their natural history, and updates in endoscopic classification and management. Recent findings Colon polyps that form from not only the adenoma, but also the serrated polyp pathway have significant risk for future progression to CRC. Therefore, correct identification and management of sessile serrated lesions can improve the quality of screening colonoscopy. Malignant polyp recognition continues to be heavily reliant on well established endoscopic classification systems and plays an important role in intraprocedural management decisions. Hot snare remains the gold standard for pedunculated polyp resection. Nonpedunculated noninvasive lesions can be effectively removed by large forceps if diminutive, but cold snare is preferred for colon polyps 3–20 mm in diameter. Larger lesions at least 20 mm require endoscopic mucosal resection. Polyps with the endoscopic appearance of submucosal invasion require surgical referral or advanced endoscopic resection in select cases. Advances in artificial intelligence may revolutionize endoscopic polyp classification and improve both patient and cost-related outcomes of colonoscopy. Summary Clinicians should be aware of the most recent updates in colon polyp classification and management to provide the best care to their patients initiating screening colonoscopy.

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Accuracy and inter-observer agreement of the nice and kudo classifications of superficial colonic lesions: a comparative study

Cited by 8 publications

References 38 publications

Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study

Utility of the narrow-band imaging international colorectal endoscopic classification for optical diagnosis of colorectal polyp histology in clinical practice: a retrospective study

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

Colon polyps: updates in classification and management

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