Objective validity of the Japan Narrow-Band Imaging Expert Team classification system for the differential diagnosis of colorectal polyps.
JNET
colon
endoscopy
magnification
polyp
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
06
11
2018
accepted:
05
03
2019
pubmed:
13
3
2019
medline:
18
2
2020
entrez:
13
3
2019
Statut:
ppublish
Résumé
The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants. Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared. Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training. The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants.
METHODS
METHODS
Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared.
RESULTS
RESULTS
Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training.
CONCLUSION
CONCLUSIONS
The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.
Types de publication
Journal Article
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
544-551Informations de copyright
© 2019 Japan Gastroenterological Endoscopy Society.
Références
Chiu HM, Chang CY, Chen CC et al. A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia. Gut 2007; 56: 373-9.
Tischendorf JJ, Wasmuth HE, Koch A et al. Value of magnifying chromoendoscopy and narrow band imaging (NBI) in classifying colorectal polyps: a prospective controlled study. Endoscopy 2007; 39: 1092-6.
Park SY, Lee SK, Kim BC et al. Efficacy of chromoendoscopy with indigocarmine for the detection of ascending colon and cecum lesions. Scand. J. Gastroenterol. 2008; 43: 878-85.
Uraoka T, Saito Y, Ikematsu H et al. Sano's capillary pattern classification for narrow-band imaging of early colorectal lesions. Dig. Endosc. 2011; 23(Suppl 1): 112-5.
Oba S, Tanaka S, Sano Y et al. Current status of narrow-band imaging magnifying colonoscopy for colorectal neoplasia in Japan. Digestion 2011; 83: 167-72.
Ikematsu H, Matsuda T, Emura F et al. Efficacy of capillary pattern type IIIA/IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms. BMC Gastroenterol. 2010; 10: 33.
Wada Y, Kashida H, Kudo SE et al. Diagnostic accuracy of pit pattern and vascular pattern analyses in colorectal lesions. Dig. Endosc. 2010; 22: 192-9.
Sano Y, Tanaka S, Kudo SE et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig. Endosc. 2016; 28: 526-33.
Iwatate M, Sano Y, Tanaka S et al. Validation study for development of the Japan NBI Expert Team classification of colorectal lesions. Dig. Endosc. 2018; 30: 642-51.
Sano Y, Hirata D, Saito Y. Japan NBI Expert Team classification: Narrow-band imaging magnifying endoscopic classification of colorectal tumors. Dig. Endosc. 2018; 30: 543-5.
Sumimoto K, Tanaka S, Shigita K et al. The diagnostic performance of JNET classification for differentiation among noninvasive, superficially invasive, and deeply invasive colorectal neoplasia. Gastrointest. Endosc. 2017; 86: 700-9.
Sumimoto K, Tanaka S, Shigita K et al. Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Gastrointest. Endosc. 2017; 85: 816-21.
Hewett DG, Tutticci NJ. Cold snare polypectomy: is there a limit to polyp size? Endoscopy 2018; 50: 356-7.
Kubosawa Y, Nishizawa T, Kinoshita S et al. Cold snare polypectomy for polyp adjacent to colonic diverticulum. VideoGIE 2018; 3: 85-6.
Shinozaki S, Kobayashi Y, Hayashi Y et al. Efficacy and safety of cold versus hot snare polypectomy for resecting small colorectal polyps: Systematic review and meta-analysis. Dig. Endosc. 2018; 30: 592-9.
Takayanagi D, Nemoto D, Isohata N et al. Histological comparison of cold versus hot snare resections of the colorectal mucosa. Dis. Colon Rectum 2018; 61: 964-70.
Yen AW, Amato A, Cadoni S et al. Underwater polypectomy without submucosal injection for colorectal lesions ≤ 20 mm in size-a multicenter retrospective observational study. Surg. Endosc. (in press).
Yoshii S, Matsumoto M. Cold snare polypectomy technique is a procedure with a low bleeding risk. Dig. Endosc. 2018; 30(Suppl 1): 51-2.
Papastergiou V, Paraskeva KD, Fragaki M et al. Cold versus hot endoscopic mucosal resection for nonpedunculated colorectal polyps sized 6-10 mm: a randomized trial. Endoscopy 2018; 50: 403-11.