Narrow-band Imaging International Colorectal Endoscopic Classification to predict polyp histology: REDEFINE study (with videos)

Repici, Alessandro; Ciscato, Camilla; Correale, Loredana; Bisschops, Raf; Bhandari, Pradeep; Dekker, Evelien; Pech, Oliver; Radaelli, Franco; Hassan, Cesare

doi:10.1016/j.gie.2016.02.020

Cited by 26 publications

(24 citation statements)

References 25 publications

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“…Furthermore, we showed that a training module on SIMPLE classification resulted in an overall NPV of 91.3%. Repici et al [26] recently demonstrated that the application of the NICE classification to the FICE digital chromoendoscopy system resulted in suboptimal accuracy and only moderate inter-observer agreement. In our study, among the three individual NICE criteria, surface and vessel features appeared to be significantly more accurate predictors than the colour criterion alone, which in turn was associated with a poor sensitivity for the prediction of adenoma.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of the SIMPLE endoscopic classification of diminutive and small colorectal polyps

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Development and validation of the SIMPLE endoscopic classification of diminutive and small colorectal polyps

et al. 2018

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“…Advanced endoscopic imaging technologies have made a significant improvement in colorectal polyp characterization. Currently only the NICE classification is used solely for the NBI technology [52] and is not reproducible when different technology is used [53]. In one study blue-light imaging (with or without magnification) was used to create a new classification for distinguishing colorectal polyps (hyperplastic, adenomatous, and invasive malignant lesions) [54].…”

Section: Artificial Intelligence and Blue Light Imaging In Colorectalmentioning

confidence: 99%

Should We Resect and Discard Low Risk Diminutive Colon Polyps

Kandel

Wallace

2019

Clin Endosc

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Diminutive colorectal polyps <5 mm are very common and almost universally benign. The current strategy of resection with histological confirmation of all colorectal polyps is costly and may increase the risk of colonoscopy. Accurate, optical diagnosis without histology can be achieved with currently available endoscopic technologies. The American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable endoscopic Innovations supports strategies for optical diagnosis of small non neoplastic polyps as long as two criteria are met. For hyperplastic appearing polyps <5 mm in recto-sigmoid colon, the negative predictive value should be at least 90%. For diminutive low grade adenomatous appearing polyps, a resect and discard strategy should be sufficiently accurate such that post-polypectomy surveillance recommendations based on the optical diagnosis, agree with a histologically diagnosis at least 90% of the time. Although the resect and discard as well as diagnose and leave behind approach has major benefits with regard to both safety and cost, it has yet to be used widely in practice. To fully implement such as strategy, there is a need for better-quality training, quality assurance, and patient acceptance. In the article, we will review the current state of the science on optical diagnose of colorectal polyps and its implications for colonoscopy practice.

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“…Recent studies [12, 13] have shown suboptimal diagnostic yields of NICE classification system in predicting pathology of small colorectal polyps; however, we believe the education program we developed in this study will facilitate sufficient and effective training in NBI interpretation in a clinical setting and potentially improve the diagnostic performance of this classification system. A prospective clinical trial on this NBI education program and diagnostic performance is currently underway.…”

Section: Discussionmentioning

confidence: 99%

A Web-Based Education Program for Colorectal Lesion Diagnosis with Narrow Band Imaging Classification

Aihara

Kumar

Thompson³

2018

Digestion

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Background: An education system for narrow band imaging (NBI) interpretation requires sufficient exposure to key features. However, access to didactic lectures by experienced teachers is limited in the United States. Aim: To develop and assess the effectiveness of a colorectal lesion identification tutorial. Methods: In the image analysis pretest, subjects including 9 experts and 8 trainees interpreted 50 white light (WL) and 50 NBI images of colorectal lesions. Results were not reviewed with subjects. Trainees then participated in an online tutorial emphasizing NBI interpretation in colorectal lesion analysis. A post-test was administered and diagnostic yields were compared to pre-education diagnostic yields. Results: Under the NBI mode, experts showed higher diagnostic yields (sensitivity 91.5% [87.3–94.4], specificity 90.6% [85.1–94.2], and accuracy 91.1% [88.5–93.7] with substantial interobserver agreement [κ value 0.71]) compared to trainees (sensitivity 89.6% [84.8–93.0], specificity 80.6% [73.5–86.3], and accuracy 86.0% [82.6–89.2], with substantial interobserver agreement [κ value 0.69]). The online tutorial improved the diagnostic yields of trainees to the equivalent level of experts (sensitivity 94.1% [90.0–96.6], specificity 89.0% [83.0–93.2], and accuracy 92.0% [89.3–94.7], p < 0.001 with substantial interobserver agreement [κ value 0.78]). Conclusions: This short, online tutorial improved diagnostic performance and interobserver agreement.

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Narrow-band Imaging International Colorectal Endoscopic Classification to predict polyp histology: REDEFINE study (with videos)

Abstract: The application of the NICE classification to FICE resulted in suboptimal accuracy and only moderate interobserver agreement.

Cited by 26 publications

References 25 publications

Development and validation of the SIMPLE endoscopic classification of diminutive and small colorectal polyps

Development and validation of the SIMPLE endoscopic classification of diminutive and small colorectal polyps

Should We Resect and Discard Low Risk Diminutive Colon Polyps

A Web-Based Education Program for Colorectal Lesion Diagnosis with Narrow Band Imaging Classification

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