Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study

Zhang, Qing Wei; Zhang, Jing Jing; Yang, Ai Ming; Sheng, Jian Qiu; Liu, Yu Lan; Li, Zhao Shen; Chen, Hai-Ying; Feng, Nan; Jiang, Qin; Jin, Peng; Zhang, Liming; Fang, Hong; Gao, Youguang; Ge, Zhi Zheng; Li, Xiao Bo

doi:10.1111/1751-2980.12841

Cited by 3 publications

(2 citation statements)

References 45 publications

(138 reference statements)

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“… 9 We evaluated if the differences between their and our results could be explained by the experience of gastroenterologist but we did not find any association, maybe because NBI formal training was not evaluated in our study and the gastroenterologist experience may not adequately represent the experience with NBI. 16 – 18 Therefore, our findings suggest that in clinical centers without formal NBI training all polyps should be removed endoscopically for histopathology evaluation. Additionally, formal NBI training should be encouraged to improve diagnostic performance with NBI.…”

Section: Discussionmentioning

confidence: 83%

Concordance between nice classification and histopathology in colonic polyps: a tertiary center experience

Buitrago-Tamayo,

Lombo-Moreno,

Ursida

et al. 2024

Clin Med Insights Gastroenterol

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Background: Narrow-Band imaging International Colorectal Endoscopic (NICE) could reduce histopathology study requirements in colorectal polyp evaluation. Local and regional studies are required to validate its utility. Objectives: To evaluate concordance between NICE classification and histopathology. Design: Prospective analytic study performed in the Hospital Universitario San Ignacio, Bogotá (Colombia) between 2021 and 2022. Methods: Concordance between NICE I, II and III classification and histopathology [Hyperplastic Polyp (HP), adenoma and deep submucosal invasive cancer (DSIC)] was evaluated using weighted kappa. Diagnostic performance was evaluated for NICE I–II versus NICE III for DSIC versus adenoma/HP. A subgroup analysis was performed for polyps ⩾10 mm and those located in the rectum, sigmoid, and left colon. Results: A total of 238 polyps from 135 patients were evaluated. Median age 67 years (IQR 58.5–74.5), 54.4% males. 23 (17.1%) had ⩾3 polyps. Of polyps, 52.1% were located on rectum, sigmoid and left colon. A total of 182 (76.5%) were <10 mm. NICE and histopathology evidenced a fair-moderate concordance (quadratic weighted kappa 0.36, linear weighted kappa 0.43). NICE classification (NICE I–II versus III) compared to histopathology (DSIC versus adenoma/HP) evidenced a sensitivity of 90.9% and specificity of 99.1%. For DSIC diagnosis specificity was ⩾95% on polyps ⩾10 mm and those left sided located. Conclusion: NICE and histopathology concordance is suboptimal. However, NICE III for DSIC diagnosis evidence good specificity. Therefore, NICE III polyps require a prompt histopathological evaluation and follow-up. Good operative characteristics stand in polyps ⩾10 mm and left sided located. NBI formal training is recommended in gastroenterology units in Latin America.

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Section: Discussionmentioning

confidence: 83%

Concordance between nice classification and histopathology in colonic polyps: a tertiary center experience

Buitrago-Tamayo,

Lombo-Moreno,

Ursida

et al. 2024

Clin Med Insights Gastroenterol

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“…In the polyp/adenoma dataset, we only included NBI images from Olympus. Narrow-band imaging international colorectal endoscopic classification (NICE) was adopted to classify the polyps (21)(22)(23). More specifically, polyps of NICE type I were classified into hyperplastic polyps while polyps of NICE type II or above should be identified as adenoma lesions (20).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the competence of an artificial intelligence-assisted colonoscopy system in clinical practice: A post hoc analysis

Zuo¹,

Dai²,

Huang³

et al. 2023

Front. Med.

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BackgroundArtificial intelligence-assisted colonoscopy (AIAC) has been proposed and validated in recent years, but the effectiveness of clinic application remains unclear since it was only validated in some clinical trials rather than normal conditions. In addition, previous clinical trials were mostly concerned with colorectal polyp identification, while fewer studies are focusing on adenoma identification and polyps size measurement. In this study, we validated the effectiveness of AIAC in the clinical environment and further investigated its capacity for adenoma identification and polyps size measurement.MethodsThe information of 174 continued patients who went for coloscopy in Chongqing Rongchang District People’s hospital with detected colon polyps was retrospectively collected, and their coloscopy images were divided into three validation datasets, polyps dataset, polyps/adenomas dataset (all containing narrow band image, NBI images), and polyp size measurement dataset (images with biopsy forceps and polyps) to assess the competence of the artificial intelligence system, and compare its diagnostic ability with endoscopists with different experiences.ResultsA total of 174 patients were included, and the sensitivity of the colorectal polyp recognition model was 99.40%, the accuracy of the colorectal adenoma diagnostic model was 93.06%, which was higher than that of endoscopists, and the mean absolute error of the polyp size measurement model was 0.62 mm and the mean relative error was 10.89%, which was lower than that of endoscopists.ConclusionArtificial intelligence-assisted model demonstrated higher competence compared with endoscopists and stable diagnosis ability in clinical use.

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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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Feasibility of using narrow band imaging international colorectal endoscopic classification for diagnosing colorectal neoplasia in China: A multicenter pilot observational study

Cited by 3 publications

References 45 publications

Concordance between nice classification and histopathology in colonic polyps: a tertiary center experience

Concordance between nice classification and histopathology in colonic polyps: a tertiary center experience

Evaluation of the competence of an artificial intelligence-assisted colonoscopy system in clinical practice: A post hoc analysis

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

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