Feasibility of a simplified narrow-band imaging classification system for Barrett’s esophagus for novice endoscopists

Furuhashi, Hiroto; Goda, Kenichi; Shimizu, Yuichi; Kato, Masayuki; Takahashi, Masakazu; Dobashi, Akira; Hirata, Koji; Oba, Ayane; Shigesawa, Taku; Inoue, Masakí; Matsui, Hiroaki; Kinoshita, Chika; Ando, Yumiko; Ikegami, Machiko; Shimoda, Tadakazu; Kato, Mototsugu

doi:10.1007/s00535-018-01537-7

Cited by 4 publications

(10 citation statements)

References 29 publications

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“…The mucosal surface of BE occasionally shows an invisible/absent mucosal pattern, which is known as a “flat pattern,” corresponding not to dysplastic but to non-dysplastic histology [ 11 ]. The flat pattern was originally defined as absence of pits and villi (i.e., invisible/absent mucosal pattern) with normal-appearing, long branching vessels [ 17 ]. The flat pattern mimics an absent micro-surface (mucosal) pattern, which is significantly suggestive of early gastric cancer [ 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…Second, the vascular pattern was classified as "visible" or "invisible." The "visible" vascular pattern included normal-appearing, long branching vessels and greenish thick vessels (GTV) previously reported and after-mentioned [16,17]. General diagnosis was rated as "regular" or "irregular" based on mucosal plus vascular patterns.…”

Section: Diagnostic Flowchart Of Jes-be Classification Systemmentioning

confidence: 99%

“…This was to enhance the diagnostic accuracy for non-dysplastic lesions [16][17][18]. This study used the modified criteria; according to these criteria, an invisible mucosal pattern without a distinct demarcation line and visible vascular patterns of long branching vessels [11,15] or GTV [16][17][18] was rated as "regular." Thus, a flat pattern was rated as "regular" and the predicted histology as "non-dysplastic" [11,[15][16][17].…”

Section: Diagnostic Flowchart Of Jes-be Classification Systemmentioning

confidence: 99%

“…f Schematic diagram of the endoscopic image shown in e less than 20 cases of SBERN, respectively. Diagnostic process of magnification NBI endoscopy for early gastric cancer is similar to that for SBERN [19][20][21][22], but partly different from that for SBERN, especially in flat pattern diagnosis [16,17]. We considered that experts should be familiar with magnification endoscopy for SBERN as well as early gastric cancer.…”

Section: Image Reviewermentioning

confidence: 99%

“…Several classifications using NBI magnification endoscopy have been proposed, thereby suggesting the high utility of the classifications for the diagnosis of SBERN [11][12][13][14]. However, none of them have been widely accepted; thus, recent studies attempted to integrate and simplify the magnifying endoscopic classifications [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study

et al. 2021

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Background Currently, no classification system using magnification endoscopy for the diagnosis of superficial Barrett’s esophagus (BE)-related neoplasia has been widely accepted. This nationwide multicenter study aimed to validate the diagnostic accuracy and reproducibility of the magnification endoscopy classification system, including the diagnostic flowchart developed by the Japan Esophageal Society—Barrett’s esophagus working group (JES-BE) for superficial Barrett’s esophagus-related neoplasms. Methods The JES-BE acquired high-definition magnification narrow-band imaging (HM-NBI) images of non-dysplastic and dysplastic BE from 10 domestic institutions. A total of 186 high-quality HM-NBI images were selected. Thirty images were used for the training phase and 156 for the validation (test) phase. We invited five non-experts and five expert reviewers. In the training phase, the reviewers discussed how to correctly predict the histology based on the JES-BE criteria. In the validation phase, they evaluated whether the criteria accurately predicted the histology results according to the diagnostic flowchart. The validation phase was performed immediately after the training phase and at 6 weeks thereafter. Results The sensitivity and specificity for all reviewers were 87% and 97%, respectively. Overall accuracy, positive predictive value, and negative predictive value were 91%, 98%, and 83%, respectively. The overall strength of inter-observer and intra-observer agreements for dysplastic histology prediction was κ = 0.77 and κ = 0.83, respectively. No significant difference in diagnostic accuracy and reproducibility between experts and non-experts was found. Conclusion The JES-BE classification system, including the diagnostic flowchart for predicting dysplastic BE, is acceptable and reliable, regardless of the clinician’s experience level.

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Section: Methodsmentioning

confidence: 99%

Section: Diagnostic Flowchart Of Jes-be Classification Systemmentioning

confidence: 99%

Section: Diagnostic Flowchart Of Jes-be Classification Systemmentioning

confidence: 99%

Section: Image Reviewermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study

et al. 2021

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A simpler diagnostic algorithm of the Japan Esophageal Society classification for Barrett’s esophagus-related superficial neoplasia

Ikenoyama,

Goda,

Fujisaki

et al. 2023

Esophagus

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Are we Missing Barrett's Esophagus in Our Busy Endoscopy Practice? Improving Detection

Dutta

2022

Journal of Digestive Endoscopy

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Barrett's esophagus (BE) denotes the replacement of stratified squamous epithelium of esophagus by columnar epithelium. It is associated with a significantly increased risk of esophageal adenocarcinoma and hence patients with BE are advised endoscopic surveillance for early detection of dysplastic and neoplastic lesions. Esophageal cancer is the sixth most common cancer in terms of incidence and mortality in India. Around 15 to 25% of esophageal cancers are adenocarcinoma. BE is likely to be an important precursor of esophageal adenocarcinoma and we may be missing patients with BE in our busy endoscopy practice. The detection of BE may be improved by identifying high-risk groups, performing thorough endoscopic examination, and applying newer imaging techniques. The high-risk group includes patients with chronic gastroesophageal reflux disease, obesity, smoking, etc. During endoscopic examination, a careful assessment of the gastroesophageal junction and identification of important landmarks such as gastroesophageal junction and Z line are essential to detect BE. Management of BE depends on the detection of dysplasia and for this four quadrant mucosal biopsy is recommended every 1 to 2 cm. However, random biopsy samples only a small area of mucosa and advanced technologies for real-time detection of dysplasia and neoplasia may overcome this limitation. In this review, we discuss the current scenario of BE in India and ways to improve the detection of BE including dysplastic lesions.

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Feasibility of a simplified narrow-band imaging classification system for Barrett’s esophagus for novice endoscopists

Cited by 4 publications

References 29 publications

Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study

Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study

A simpler diagnostic algorithm of the Japan Esophageal Society classification for Barrett’s esophagus-related superficial neoplasia

Are we Missing Barrett's Esophagus in Our Busy Endoscopy Practice? Improving Detection

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