Tags

Type your tag names separated by a space and hit enter

Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging.
Gastroenterology 2012; 143(3):599-607.e1G

Abstract

BACKGROUND & AIMS

Almost all colorectal polyps ≤ 5 mm are benign, yet current practice requires costly pathologic analysis. We aimed to develop and evaluate the validity of a simple narrow-band imaging (NBI)-based classification system for differentiating hyperplastic from adenomatous polyps.

METHODS

The study was conducted in 4 phases: (1) evaluation of accuracy and reliability of histologic prediction by NBI-experienced colonoscopists; (2) development of a classification based on color, vessels, and surface pattern criteria, using a modified Delphi method; (3) validation of the component criteria by people not experienced in endoscopy or NBI analysis (25 medical students, 19 gastroenterology fellows) using 118 high-definition colorectal polyp images of known histology; and (4) validation of the classification system by NBI-trained gastroenterology fellows, using still images. We performed a pilot evaluation during real-time colonoscopy.

RESULTS

We developed a classification system for the endoscopic diagnosis of colorectal polyp histology and established its predictive validity. When all 3 criteria were used, the specificity ranged from 94.9% to 100% and the combined sensitivity ranged from 8.5% to 61.0%. The specificities of the individual criteria were lower although the sensitivities were higher. During real-time colonoscopy, endoscopists made diagnoses with high confidence for 75% of consecutive small colorectal polyps, with 89% accuracy, 98% sensitivity, and 95% negative predictive values.

CONCLUSIONS

We developed and established the validity of an NBI classification system that can be used to diagnose colorectal polyps. In preliminary real-time evaluation, the system allowed endoscopic diagnoses of colorectal polyp histology.

Authors+Show Affiliations

Indiana University School of Medicine, Indianapolis, Indiana; The University of Queensland School of Medicine, Brisbane, Australia.Veterans Affairs Palo Alto Health Care System, Palo Alto, California; Stanford University School of Medicine, Stanford, California.Sano Hospital, Kobe, Japan.Hiroshima University, Hiroshima, Japan.Wolfson Unit for Endoscopy and Imperial College London, St. Marks Hospital, London, United Kingdom.Hôpital Edouard-Herriot, Lyon, France.Veterans Affairs Palo Alto Health Care System, Palo Alto, California; Stanford University School of Medicine, Stanford, California.Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: drex@iupui.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Study
Video-Audio Media

Language

eng

PubMed ID

22609383

Citation

Hewett, David G., et al. "Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-band Imaging." Gastroenterology, vol. 143, no. 3, 2012, pp. 599-607.e1.
Hewett DG, Kaltenbach T, Sano Y, et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology. 2012;143(3):599-607.e1.
Hewett, D. G., Kaltenbach, T., Sano, Y., Tanaka, S., Saunders, B. P., Ponchon, T., ... Rex, D. K. (2012). Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology, 143(3), pp. 599-607.e1. doi:10.1053/j.gastro.2012.05.006.
Hewett DG, et al. Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-band Imaging. Gastroenterology. 2012;143(3):599-607.e1. PubMed PMID: 22609383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. AU - Hewett,David G, AU - Kaltenbach,Tonya, AU - Sano,Yasushi, AU - Tanaka,Shinji, AU - Saunders,Brian P, AU - Ponchon,Thierry, AU - Soetikno,Roy, AU - Rex,Douglas K, Y1 - 2012/05/15/ PY - 2011/12/20/received PY - 2012/05/03/revised PY - 2012/05/06/accepted PY - 2012/5/22/entrez PY - 2012/5/23/pubmed PY - 2012/11/7/medline SP - 599 EP - 607.e1 JF - Gastroenterology JO - Gastroenterology VL - 143 IS - 3 N2 - BACKGROUND & AIMS: Almost all colorectal polyps ≤ 5 mm are benign, yet current practice requires costly pathologic analysis. We aimed to develop and evaluate the validity of a simple narrow-band imaging (NBI)-based classification system for differentiating hyperplastic from adenomatous polyps. METHODS: The study was conducted in 4 phases: (1) evaluation of accuracy and reliability of histologic prediction by NBI-experienced colonoscopists; (2) development of a classification based on color, vessels, and surface pattern criteria, using a modified Delphi method; (3) validation of the component criteria by people not experienced in endoscopy or NBI analysis (25 medical students, 19 gastroenterology fellows) using 118 high-definition colorectal polyp images of known histology; and (4) validation of the classification system by NBI-trained gastroenterology fellows, using still images. We performed a pilot evaluation during real-time colonoscopy. RESULTS: We developed a classification system for the endoscopic diagnosis of colorectal polyp histology and established its predictive validity. When all 3 criteria were used, the specificity ranged from 94.9% to 100% and the combined sensitivity ranged from 8.5% to 61.0%. The specificities of the individual criteria were lower although the sensitivities were higher. During real-time colonoscopy, endoscopists made diagnoses with high confidence for 75% of consecutive small colorectal polyps, with 89% accuracy, 98% sensitivity, and 95% negative predictive values. CONCLUSIONS: We developed and established the validity of an NBI classification system that can be used to diagnose colorectal polyps. In preliminary real-time evaluation, the system allowed endoscopic diagnoses of colorectal polyp histology. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/22609383/Validation_of_a_simple_classification_system_for_endoscopic_diagnosis_of_small_colorectal_polyps_using_narrow_band_imaging_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(12)00687-7 DB - PRIME DP - Unbound Medicine ER -