Narrow Band Imaging Without High Magnification to Differentiate Polyps During Real-Time Colonoscopy: Improvement with Experience

Rogart, Jason N.; Siddiqui, Uzma D.; Jain, Dhanpat; Tal, Oren; Lim, Joseph K.; Jamidar, Priya A.; Aslanian, Harry R.

doi:10.1016/j.gie.2008.03.117

Cited by 14 publications

(26 citation statements)

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“…We identified two studies that address the potential learning curve for real-time endoscopic diagnosis. In Rogart et al 's26 series of 265 polyps in 131 patients, three of four endoscopists significantly improved their accuracy in the second half of the study compared with the first from 74% to 87%, respectively. In that study, endoscopists received feedback every 2 weeks about the accuracy of their endoscopic diagnosis.…”

Section: Discussionmentioning

confidence: 92%

Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics

McGill

Εvangelou

Ioannidis

et al. 2013

Gut

155

104

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PurposeMany studies have reported on the use of narrow band imaging (NBI) colonoscopy to differentiate neoplastic from non-neoplastic colorectal polyps. It has potential to replace pathological diagnosis of diminutive polyps. We aimed to perform a systematic review and meta-analysis on the real-time diagnostic operating characteristics of NBI colonoscopy.MethodsWe searched PubMed, SCOPUS and Cochrane databases and abstracts. We used a two-level bivariate meta-analysis following a random effects model to summarise the data and fit hierarchical summary receiver-operating characteristic (HSROC) curves. The area under the HSROC curve serves as an indicator of the diagnostic test strength. We calculated summary sensitivity, specificity and negative predictive value (NPV). We assessed agreement of surveillance interval recommendations based on endoscopic diagnosis compared to pathology.ResultsFor NBI diagnosis of colorectal polyps, the area under the HSROC curve was 0.92 (95% CI 0.90 to 0.94), based on 28 studies involving 6280 polyps in 4053 patients. The overall sensitivity was 91.0% (95% CI 87.6% to 93.5%) and specificity was 82.6% (95% CI 79.0% to 85.7%). In eight studies (n=2146 polyps) that used high-confidence diagnostic predictions, sensitivity was 93.8% and specificity was 83.3%. The NPVs exceeded 90% when 60% or less of all polyps were neoplastic. Surveillance intervals based on endoscopic diagnosis agreed with those based on pathology in 92.6% of patients (95% CI 87.9% to 96.3%).ConclusionsNBI diagnosis of colorectal polyps is highly accurate—the area under the HSROC curve exceeds 0.90. High-confidence predictions provide >90% sensitivity and NPV. It shows high potential for real-time endoscopic diagnosis.

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Section: Discussionmentioning

confidence: 92%

Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics

McGill

Εvangelou

Ioannidis

et al. 2013

Gut

155

104

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“…First a more simple, reproducible and validated way of characterize colon lesions is needed, especially in community practice. Learning the technique is also crucial because when learning curve is achieved NBI performs significantly better [68]. Moreover, implementing PIVI guidelines [33] implies accepting a 10% rate of false negative when in vivo assessing histology of rectal polyps.…”

Section: Resultsmentioning

confidence: 99%

In vivo Optical Diagnosis of Polyp Histology: Can We Omit Pathological Examination of Diminutive Polyps?

Bustamante-Balén¹

2013

Colonoscopy and Colorectal Cancer Screening - Future Directions

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“…Several NBI classifications that do not use magnification are applied for optical diagnosis, including the NICE classification, the vascular pattern intensity (VPI), and the Kudo pit pattern . The NICE classification, including the evaluation of color, surface and vessel characteristics of the lesions, is a simplified combination of the VPI and the Kudo pit pattern and is currently the most widely used tool .…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, conventional white light endoscopy (WLE) has limited accuracy for predicting the histology of adenomas . With the recent progress of colonoscopy techniques, image‐enhanced endoscopy modalities, in particular non‐magnified narrow‐band imaging (NBI), have shown a high accuracy in the optical prediction of adenomas . Therefore, NBI can conceivably avoid unnecessary histological examination and the subsequent in vivo endoscopic assessment.…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

Yang

et al. 2020

J of Digest Diseases

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Objective We aimed to investigate whether Chinese endoscopists without narrow‐band imaging (NBI) experiences could achieve high accuracy in the real‐time diagnosis of colorectal polyps using NBI International Colorectal Endoscopic (NICE) classification after web‐based training. Methods Altogether 15 endoscopists from five centers with no NBI experiences followed a short, web‐based training program on the NICE classification and took web‐based test. Their performances were compared with 15 matched experienced endoscopists with no NBI experience who received no NBI training. These 15 trained endoscopists then made real‐time diagnoses of colorectal neoplasia. A logistic regression was used to assess potential predictors of diagnostic performance. Results Compared with those who received no training, trained endoscopists achieved comparable overall accuracy (85.3% vs 83.1%, P = 0.408) and accuracy at a high‐confidence level (87.0% vs 86.0%, P = 0.670), but had a higher confidence rate (86.1% vs 83.7%, P = 0.004) for the diagnosis of neoplasia. Real‐time diagnostic accuracy, sensitivity and specificity were 94.3% (95% confidence interval [CI] 91.5%‐96.2%), 96.2% (95% CI 93.4%‐97.9%) and 85.3% (95% CI 74.8%‐92.1%) at high‐confidence level. The high‐confidence level was the strongest predictor of real‐time diagnostic accuracy (odds ratio 12.66, P < 0.001). Conclusions Web‐based training can improve the confidence level of endoscopists in accurately diagnosing colorectal polyps using the NICE classification. Chinese endoscopists can achieve high accuracy in diagnosing colorectal neoplasia at a high confidence level (ClinicalTrials ID: NCT02033980).

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Narrow Band Imaging Without High Magnification to Differentiate Polyps During Real-Time Colonoscopy: Improvement with Experience

Cited by 14 publications

References 0 publications

Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics

Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics

In vivo Optical Diagnosis of Polyp Histology: Can We Omit Pathological Examination of Diminutive Polyps?

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

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