Interobserver and intra-observer consistency in the endoscopic assessment of colonic pit patterns

Huang, Qilin; Fukami, Norio; Kashida, Hiroshi; Takeuchi, Takahito; Kogure, Etsuko; Kurahashi, Toshinori; Stahl, Etienne; Kudo, Yoshihisa; Kimata, Hiroyuki; Kudo, Shin Ei

doi:10.1016/s0016-5107(04)01880-2

Cited by 91 publications

(49 citation statements)

References 16 publications

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“…38,39 We have documented all resected lesions, with pit-pattern findings, diameter, and final pathological findings. 40,41 The pit patterns (Fig. 2) were classified as I, II, IIIs (small), IIIl (large), IV, Vi (irregular), and Vn (nonstructural).…”

Section: Endoscopic Prediction Of Histologymentioning

confidence: 99%

Early colorectal cancer: concept, diagnosis, and management

Kashida

Kudo

2006

Int J Clin Oncol

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In colorectal cancers, although flat and depressed-type lesions are found by regular endoscopic view, magnification and pit-pattern observation are vital parts of the precise diagnosis of the lesion. The depressed-type lesions appear to have a prominent tendency to show malignant characteristics, and the recognition and timely treatment of such lesions is important for improving the morbidity and mortality of colorectal cancer. Chromoscopy is mandatory for an accurate diagnosis of these lesions. The pit-pattern classification correlates well with actual histological findings and can provide important additional information prior to endoscopic treatment of the lesion.

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Section: Endoscopic Prediction Of Histologymentioning

confidence: 99%

Early colorectal cancer: concept, diagnosis, and management

Kashida

Kudo

2006

Int J Clin Oncol

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“…Eight years have past and recently reproducibility was demonstrated [16] , in an altered simplified three patterns classification with management consequences or prognosis implications: I and Ⅱ as non-neoplastic; ⅢL and IV as neoplastic; and Ⅲs and V as neoplastic possibly invasive.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty in proposing a guide of practice for the management of patients with atrophic chronic gastritis and intestinal metaplasia may be related to the fact that conventional endoscopy used in most studies shows a low reproducibility and poor relation with histology at diagnosing these diffuse mucosal changes and minute lesions of cancer [7,8] . For the last ten years, several studies considered magnification and high-resolution endoscopy in conjunction with chromoendoscopy for the diagnosis of precancerous [9][10][11][12][13][14] and neoplastic lesions [15][16][17][18][19][20][21][22] , in the gastrointestinal tract. However, mostly authors focused on the validity assessment and rarely were reliability or the learning of each group description defined [16,17] .…”

Section: Introductionmentioning

confidence: 99%

Web-based system for training and dissemination of a magnification chromoendoscopy classification

Dinis-Ribeiro¹,

Cruz‐Correia²,

Costa-Santos³

et al. 2008

WJG

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AIM:To evaluate the use of web-based technologies to assess the learning curve and reassess reproducibility of a simplified version of a classification for gastric magnification chromoendoscopy (MC). METHODS: As part of a multicenter trial, a hybrid approach was taken using a CD-ROM, with 20 films of MC lasting 5 s each and an "autorun" file triggering a local HTML frameset referenced to a remote questionnaire through an Internet connection. Three endoscopists were asked to prospectively and independently classify 10 of these films randomly selected with at least 3 d apart. The answers were centrally stored and returned to participants together with adequate feedback with the right answer. RESULTS: For classification in 3 groups, both intra-[Cohen's kappa (κ) = 0.79-1.00 to 0.89-1.00] and inter-observer agreement increased from 1st (moderate) to 6th observation (κ = 0.94). Also, agreement with reference increased in the last observations (0.90, 1.00 and 1.00, for observers A, B and C, respectively). Validity of 100% was obtained by all observers at their 4th observation. When a 4th (sub)group was considered, inter-observer agreement was almost perfect (κ = 0.92) at 6th observation. The relation with reference clearly improved into κ (0.93-1.00) and sensitivity (75%-100%) at their 6th observations. CONCLUSION: This MC classification seems to be easily explainable and learnable as shown by excellent intra-and inter-observer agreement, and improved agreement with reference. A web system such as the one used in this study may be useful for endoscopic or other image based diagnostic procedures with respect to definition, education and dissemination.

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“…Na análise isolada para cada padrão de criptas, a concordância entre os três observadores foi também bastante aproximada, exceto quanto ao tipo V (0,330). Em estudo semelhante, Huang et al (30) obtiveram um índice estimado de Kappa de 0,716, mostrando excelente concordância entre os seis observadores selecionados. É possível que esse resultado tão expressivo tenha sido favorecido pela utilização de alta magnificação, que teoricamente pode aguçar a capacidade de interprretação para alguns padrões de criptas, principalmente os pequenos (IIIS e V).…”

Section: Discussionunclassified

Colonoscopia com magnificação de imagem: análise da variação interobservadores para os padrões de criptas e comparação das imagens endoscópicas com os achados histopatológicos

Zanoni

Cutait

Averbach

et al. 2006

Rev bras. colo-proctol.

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RESUMO: A colonoscopia com magnificação de imagem (CMI) é considerada uma técnica que possibilita o diagnóstico diferencial entre lesões colorretais neoplásicas e não-neoplásicas. Este estudo avaliou a variação da concordância interobservadores para os padrões de criptas através de três endoscopistas experientes com a classificação de INTRODUÇÃOO CCR constitui-se em neoplasia frequente no mundo, tendo considerável participação na mortandade por câncer. A prevenção secundária para o CCR é altamente eficaz (1,2) e possibilita a redução considerá-vel em sua mortalidade para os indivíduos submetidos a rastreamento por colonoscopia por permitir a identificação e ressecção dos pólipos colorretais, lesões precursoras do câncer (3) .Contudo, deve-se considerar a possibilidade da não-detecção de lesões polipóides (4,5,6) , a existência de lesões planas diminutas que apresentam comportamento biológico mais agressivo em relação as polipóides do mesmo tamanho (7,8,9,10) ou, então, presença de carcinomas precoces plano-deprimidos que podem ser invasivos, mesmo quando muito pequenos (11,12).Com o advento dos videoendoscópicos de alta resolução, lesões planas e plano-deprimidas, consideradas um desafio ao diagnóstico por colonoscopia convencional, passaram a ser mais frequentemente detectadas (13,14,15,16) e melhor definidas com o emprego da cromoendoscopia (CE) e colonoscopia com magnificação de imagem (CMI). Estas inovações permitiram também o diagnóstico diferencial endoscópico entre lesões neoplásicas e não-neoplásicas (11,17,18,19,20,21,22) .O estabelecimento do diagnóstico histológico de uma lesão ainda durante a endoscopia poderia eco-

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Interobserver and intra-observer consistency in the endoscopic assessment of colonic pit patterns

Cited by 91 publications

References 16 publications

Early colorectal cancer: concept, diagnosis, and management

Early colorectal cancer: concept, diagnosis, and management

Web-based system for training and dissemination of a magnification chromoendoscopy classification

Colonoscopia com magnificação de imagem: análise da variação interobservadores para os padrões de criptas e comparação das imagens endoscópicas com os achados histopatológicos

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