Narrow-band imaging for scar (NBI-SCAR) classification: from conception to multicenter validation

Pu, Leonardo Zorrón Cheng Tao; Chiam, Keng Hoong; Yamamura, Takeshi; Nakamura, Masanao; Berzin, Tyler M.; Mir, Fahad F.; Moura, Eduardo Guimarães Hourneaux de; Neto, Antônio Martins Figueiredo; Koay, Doreen Siew Ching; Loong, Cheong Kuan; Ovenden, Amanda; Edwards, Suzanne; Burt, Alastair D.; Hirooka, Yoshiki; Fujishiro, Mitsuhiro; Singh, Rajvinder

doi:10.1016/j.gie.2019.08.036

Cited by 11 publications

(10 citation statements)

References 18 publications

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“…The NPV for high confidence predictions with HD-WLE was 98.1 % (95 %CI 94.7 %-99.4 %), HD-WLE with near focus was 98.8 % (95 %CI 95.6 %-99.7 %), NBI was 98.8 % (95 %CI 95.6 %-99.7 %), and NBI with near focus was 100 % (95 %CI 97.8 %-100 %) [7]. A further study (NBI-SCAR) developed and validated an NBI classification for RRA using videos rated by endoscopists with varying levels of experience (trainees and experts) [8]. The NPV for high confidence predictions using this system was 100 % (95 %CI 96.1 %-100 %), although it has not been validated in a clinical setting.…”

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confidence: 99%

Can we stop routine biopsy of post-endoscopic mucosal resection scars?

Burgess

Bourke

2023

Endoscopy

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confidence: 99%

Can we stop routine biopsy of post-endoscopic mucosal resection scars?

Burgess

Bourke

2023

Endoscopy

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“…Although the results suggested high sensitivity and accuracy, no official classification was raised. Therefore, some researchers developed the narrow-band imaging for scar (NBI-SCAR) classification in 2020 ( 142 ). By evacuating the scar with NBI, they described the key characteristics of both recurrent and non-recurrent disease.…”

Section: Scarmentioning

confidence: 99%

A narrative review: narrow-band imaging endoscopic classifications

Yang¹,

Liu²,

Sun³

et al. 2023

Quant Imaging Med Surg

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Background and Objective: With the development of endoscopic techniques, narrow-band imaging (NBI) has been widely used in the diagnosis of various types of diseases. NBI can detect mucosal lesions at an early stage and different classification strategies have been established to help clinicians in disease diagnosis. However, there is currently no consensus for the classification criteria. This report summarizes the current classifications of diseases using NBI, so as to provide a comprehensive understanding of the various manifestations of mucosal lesions under NBI, and to promote the development of more practical NBI classifications.Methods: The PubMed database was searched for English language articles published between January 1994 and November 2021 using the keywords 'narrow band imaging', 'NBI', and 'classification'.

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“…However, recent studies have provided new evidence on the efficacy of advanced endoscopic imaging in the detection of residual or recurrent lesions in post-EMR scars [9][10][11][12]. A prospective single-center study, which analyzed 183 scars using systematic narrow-band imaging (NBI) after WLE, showed significantly higher sensitivity and negative predictive values (NPVs) for detection of endoscopic residual neoplasia in a combination of WLE plus NBI vs. WLE alone (93.3 % vs. 66.7 % and 98.6 % vs. 93.6 %, respectively) [9].…”

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confidence: 99%

“…NBI sensitivity was significantly higher compared with WLE (100 % vs. 73.7 %; P < 0.05). The authors concluded that NBI evaluation had a high sensitivity and NPV for exclusion of recurrence when used by endoscopists who were experienced in colonoscopy and NBI [12].…”

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confidence: 99%

“…However, the additional benefit of virtual chromoendoscopy in post-EMR scar assessment remains unproven. Most prospective studies with higher diagnostic yield for chromoendoscopy reported real-time assessment of diagnostic yield per sequentially assessed imaging modality, generally chromoendoscopy after WLE [9,10,12]. Therefore, the assessment of any subsequent imaging modality was biased by previous modalities, and the only existing randomized crossover trial was underpowered [11].…”

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Can white-light endoscopy or narrow-band imaging avoid biopsy of colorectal endoscopic mucosal resection scars? A multicenter randomized single-blind crossover trial

et al. 2023

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Background and aims: Current guidelines suggest that routine biopsy of post-endoscopic mucosal resection (EMR) scars can be abandoned, provided that a standardized imaging protocol with virtual chromoendoscopy is used. However, few studies have examined the accuracy of advanced endoscopic imaging, such as Narrow Band Imaging (NBI) versus White Light Endoscopy (WLE) to predict histological recurrence. We aimed to assess whether NBI accuracy is superior to WLE and whether one or both techniques can replace biopsies. Patients and methods: Multicentre, randomized, patient-blinded, crossover trial, with consecutive patients undergoing the first colonoscopy after EMR of lesions ≥20mm. Computer-generated randomization and opaque envelope concealed allocation. Patients were randomly assigned to scar examination with NBI followed by WLE (NBI+WLE), or WLE followed by NBI (WLE+NBI). Histology was the reference method, with biopsies being performed in all tissues, either or not showing recurrence. Results: The study included 203 scars, 103 in group NBI+WLE and 100 in group WLE+NBI. Recurrence was confirmed histologically in 29.6% of the scars. The diagnostic accuracy of NBI was not statistically different from WLE 95% (95%CI, 92%-98%) vs. 94% (95%CI, 90%-97%); P=0.48). When assessing NBI vs. WLE, the negative predictive values were (NPV) 96% (95% CI, 93%-99%) vs. 93% (95% CI, 89%-97%), not reaching statistically significance (P=0.06). Conclusions: The accuracy of NBI for the diagnosis of recurrence was not superior to that of WLE. Endoscopic assessment of EMR scars with WLE and NBI achieved a NPV that precludes routine biopsy in cases of negative optical diagnosis.

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Narrow-band imaging for scar (NBI-SCAR) classification: from conception to multicenter validation

Cited by 11 publications

References 18 publications

Can we stop routine biopsy of post-endoscopic mucosal resection scars?

Can we stop routine biopsy of post-endoscopic mucosal resection scars?

A narrative review: narrow-band imaging endoscopic classifications

Can white-light endoscopy or narrow-band imaging avoid biopsy of colorectal endoscopic mucosal resection scars? A multicenter randomized single-blind crossover trial

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