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Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification.
Oncology 2017; 93 Suppl 1:49-54O

Abstract

OBJECTIVE

The Japan NBI Expert Team (JNET) proposed a new narrow band imaging (NBI) classification system for colorectal tumors in June 2014. In this classification system, types 1, 2A, 2B, and 3 correspond to hyperplastic polyps (HPs) including sessile serrated polyps (SSPs), low-grade dysplasia (LGD), high-grade dysplasia (HGD) to shallow submucosal invasive (SM-s) carcinomas, and deep submucosal invasive (SM-d) carcinomas, respectively.

METHODS

To validate this system, we performed a retrospective image evaluation study, in which 199 colorectal tumors previously assessed by NBI magnifying endoscopy were classified by 3 blinded experienced colonoscopists using the JNET system. The results were compared with the final pathological diagnoses to determine the JNET classification's accuracy. The interobserver agreement was calculated, and the intraobserver agreement was assessed after 6 months.

RESULTS

The final pathological diagnoses identified 14 HPs/SSPs, 127 LGDs, 22 HGDs, 19 SM-s carcinomas, and 17 SM-d carcinomas. The respective sensitivities, specificities, positive predictive value, negative predictive value, and accuracies were as follows: Type 1, 85.7, 99.5, 92.3, 98.9, and 98.5%; Type 2A, 96.0, 81.9, 90.3, 92.1, and 90.9%; Type 2B, 75.6%, 90.5, 67.3, 93.4, and 87.4%; and Type 3, 29.4%, 100, 100, 93.8, and 94.0%. The interobserver agreement and the intraobserver agreement were moderate (κ value: 0.52) and excellent (κ value: 0.88), respectively. Lesions presenting as Type 2B during NBI comprised a range of colorectal tumors, including HGDs, SM-s, and SM-d.

CONCLUSIONS

The JNET classification was useful for the diagnosis of HPs/SSPs, LGDs, and SM-d, but not SM-s lesions. For low-confidence cases, magnified chromoendoscopy is recommended to ensure correct diagnoses.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29258091

Citation

Komeda, Yoriaki, et al. "Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification." Oncology, vol. 93 Suppl 1, 2017, pp. 49-54.
Komeda Y, Kashida H, Sakurai T, et al. Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification. Oncology. 2017;93 Suppl 1:49-54.
Komeda, Y., Kashida, H., Sakurai, T., Asakuma, Y., Tribonias, G., Nagai, T., ... Kudo, M. (2017). Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification. Oncology, 93 Suppl 1, pp. 49-54. doi:10.1159/000481230.
Komeda Y, et al. Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification. Oncology. 2017;93 Suppl 1:49-54. PubMed PMID: 29258091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification. AU - Komeda,Yoriaki, AU - Kashida,Hiroshi, AU - Sakurai,Toshiharu, AU - Asakuma,Yutaka, AU - Tribonias,George, AU - Nagai,Tomoyuki, AU - Kono,Masashi, AU - Minaga,Kosuke, AU - Takenaka,Mamoru, AU - Arizumi,Tadaaki, AU - Hagiwara,Satoru, AU - Matsui,Shigenaga, AU - Watanabe,Tomohiro, AU - Nishida,Naoshi, AU - Chikugo,Takaaki, AU - Chiba,Yasutaka, AU - Kudo,Masatoshi, Y1 - 2017/12/20/ PY - 2017/12/20/entrez PY - 2017/12/20/pubmed PY - 2017/12/22/medline KW - Colorectal tumors KW - Japan NBI Expert Team (JNET) classification KW - Magnifying endoscopy KW - NBI International Colorectal Endoscopic (NICE) classification KW - Narrow band imaging SP - 49 EP - 54 JF - Oncology JO - Oncology VL - 93 Suppl 1 N2 - OBJECTIVE: The Japan NBI Expert Team (JNET) proposed a new narrow band imaging (NBI) classification system for colorectal tumors in June 2014. In this classification system, types 1, 2A, 2B, and 3 correspond to hyperplastic polyps (HPs) including sessile serrated polyps (SSPs), low-grade dysplasia (LGD), high-grade dysplasia (HGD) to shallow submucosal invasive (SM-s) carcinomas, and deep submucosal invasive (SM-d) carcinomas, respectively. METHODS: To validate this system, we performed a retrospective image evaluation study, in which 199 colorectal tumors previously assessed by NBI magnifying endoscopy were classified by 3 blinded experienced colonoscopists using the JNET system. The results were compared with the final pathological diagnoses to determine the JNET classification's accuracy. The interobserver agreement was calculated, and the intraobserver agreement was assessed after 6 months. RESULTS: The final pathological diagnoses identified 14 HPs/SSPs, 127 LGDs, 22 HGDs, 19 SM-s carcinomas, and 17 SM-d carcinomas. The respective sensitivities, specificities, positive predictive value, negative predictive value, and accuracies were as follows: Type 1, 85.7, 99.5, 92.3, 98.9, and 98.5%; Type 2A, 96.0, 81.9, 90.3, 92.1, and 90.9%; Type 2B, 75.6%, 90.5, 67.3, 93.4, and 87.4%; and Type 3, 29.4%, 100, 100, 93.8, and 94.0%. The interobserver agreement and the intraobserver agreement were moderate (κ value: 0.52) and excellent (κ value: 0.88), respectively. Lesions presenting as Type 2B during NBI comprised a range of colorectal tumors, including HGDs, SM-s, and SM-d. CONCLUSIONS: The JNET classification was useful for the diagnosis of HPs/SSPs, LGDs, and SM-d, but not SM-s lesions. For low-confidence cases, magnified chromoendoscopy is recommended to ensure correct diagnoses. SN - 1423-0232 UR - https://www.unboundmedicine.com/medline/citation/29258091/Magnifying_Narrow_Band_Imaging__NBI__for_the_Diagnosis_of_Localized_Colorectal_Lesions_Using_the_Japan_NBI_Expert_Team__JNET__Classification_ L2 - https://www.karger.com?DOI=10.1159/000481230 DB - PRIME DP - Unbound Medicine ER -