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Additional chromoendoscopy for colorectal lesions initially diagnosed with low confidence by magnifying narrow-band imaging: Can it improve diagnostic accuracy?
Dig Endosc 2018; 30 Suppl 1:45-50DE

Abstract

BACKGROUND AND AIM

Magnifying chromoendoscopy has been one of the most reliable diagnostic methods for distinguishing neoplastic from non-neoplastic lesions. The aim of this prospective study was to clarify the clinical usefulness of magnifying chromoendoscopy for colorectal polyps initially diagnosed with low confidence (LC) by magnifying narrow-band imaging (NBI).

METHODS

Consecutive adult patients who underwent total colonoscopic examination with magnifying NBI between July and December 2016 at Sano Hospital were prospectively recruited. Endoscopists were asked to carry out additional magnifying chromoendoscopy for cases that had been initially diagnosed as Japan NBI Expert Team (JNET) Type 1 or 2A with LC by magnifying NBI. We investigated the diagnostic performance of magnifying NBI for polyps diagnosed as JNET Type 1 or 2A with LC (first phase) and that of subsequent magnifying chromoendoscopy (second phase) in differentiating neoplasia from non-neoplasia.

RESULTS

In 50 patients, we analyzed 53 polyps classified as JNET Type 1 or 2A with LC prediction. Accuracy and negative predictive value of magnifying NBI (first phase) were 58.5% (95% CI, 44.1-71.9%) and 66.0% (95% CI, 36.6-77.9%), and those of magnifying chromoendoscopy (second phase) were 66.0% (95% CI, 51.7-78.5%) and 61.1% (95% CI, 43.5-76.9%), respectively.

CONCLUSION

Regardless of the findings of additional chromoendoscopy, all polyps should be resected and submitted for histopathological examination when the confidence level in differentiating adenomatous from hyperplastic polyps by magnifying NBI is low.

Authors+Show Affiliations

Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.Department of Pathology, Shinko Hospital, Hyogo, Japan.Department of Pathology, Shinko Hospital, Hyogo, Japan.Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29658652

Citation

Utsumi, Takahiro, et al. "Additional Chromoendoscopy for Colorectal Lesions Initially Diagnosed With Low Confidence By Magnifying Narrow-band Imaging: Can It Improve Diagnostic Accuracy?" Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society, vol. 30 Suppl 1, 2018, pp. 45-50.
Utsumi T, Iwatate M, Sunakawa H, et al. Additional chromoendoscopy for colorectal lesions initially diagnosed with low confidence by magnifying narrow-band imaging: Can it improve diagnostic accuracy? Dig Endosc. 2018;30 Suppl 1:45-50.
Utsumi, T., Iwatate, M., Sunakawa, H., Teramoto, A., Hirata, D., Hattori, S., ... Sano, Y. (2018). Additional chromoendoscopy for colorectal lesions initially diagnosed with low confidence by magnifying narrow-band imaging: Can it improve diagnostic accuracy? Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society, 30 Suppl 1, pp. 45-50. doi:10.1111/den.13055.
Utsumi T, et al. Additional Chromoendoscopy for Colorectal Lesions Initially Diagnosed With Low Confidence By Magnifying Narrow-band Imaging: Can It Improve Diagnostic Accuracy. Dig Endosc. 2018;30 Suppl 1:45-50. PubMed PMID: 29658652.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additional chromoendoscopy for colorectal lesions initially diagnosed with low confidence by magnifying narrow-band imaging: Can it improve diagnostic accuracy? AU - Utsumi,Takahiro, AU - Iwatate,Mineo, AU - Sunakawa,Hironori, AU - Teramoto,Akira, AU - Hirata,Daizen, AU - Hattori,Santa, AU - Sano,Wataru, AU - Hasuike,Noriaki, AU - Ichikawa,Kazuhito, AU - Fujimori,Takahiro, AU - Sano,Yasushi, PY - 2018/03/08/received PY - 2018/03/10/accepted PY - 2018/4/17/entrez PY - 2018/4/17/pubmed PY - 2018/10/3/medline KW - Japan NBI Expert Team (JNET) KW - adenoma KW - chromoendoscopy KW - magnifying endoscopy KW - narrow-band imaging SP - 45 EP - 50 JF - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society JO - Dig Endosc VL - 30 Suppl 1 N2 - BACKGROUND AND AIM: Magnifying chromoendoscopy has been one of the most reliable diagnostic methods for distinguishing neoplastic from non-neoplastic lesions. The aim of this prospective study was to clarify the clinical usefulness of magnifying chromoendoscopy for colorectal polyps initially diagnosed with low confidence (LC) by magnifying narrow-band imaging (NBI). METHODS: Consecutive adult patients who underwent total colonoscopic examination with magnifying NBI between July and December 2016 at Sano Hospital were prospectively recruited. Endoscopists were asked to carry out additional magnifying chromoendoscopy for cases that had been initially diagnosed as Japan NBI Expert Team (JNET) Type 1 or 2A with LC by magnifying NBI. We investigated the diagnostic performance of magnifying NBI for polyps diagnosed as JNET Type 1 or 2A with LC (first phase) and that of subsequent magnifying chromoendoscopy (second phase) in differentiating neoplasia from non-neoplasia. RESULTS: In 50 patients, we analyzed 53 polyps classified as JNET Type 1 or 2A with LC prediction. Accuracy and negative predictive value of magnifying NBI (first phase) were 58.5% (95% CI, 44.1-71.9%) and 66.0% (95% CI, 36.6-77.9%), and those of magnifying chromoendoscopy (second phase) were 66.0% (95% CI, 51.7-78.5%) and 61.1% (95% CI, 43.5-76.9%), respectively. CONCLUSION: Regardless of the findings of additional chromoendoscopy, all polyps should be resected and submitted for histopathological examination when the confidence level in differentiating adenomatous from hyperplastic polyps by magnifying NBI is low. SN - 1443-1661 UR - https://www.unboundmedicine.com/medline/citation/29658652/Additional_chromoendoscopy_for_colorectal_lesions_initially_diagnosed_with_low_confidence_by_magnifying_narrow_band_imaging:_Can_it_improve_diagnostic_accuracy L2 - https://doi.org/10.1111/den.13055 DB - PRIME DP - Unbound Medicine ER -