Diagnosis of colorectal lesions with the magnifying narrow-band imaging system

Wada, Yoshiki; Kudo, Shin‐ei; Kashida, Hiroshi; Ikehara, Nobunao; Inoue, Haruhiro; Yamamura, Fuyuhiko; Ohtsuka, Kazuo; Hamatani, Shigeharu

doi:10.1016/j.gie.2009.01.040

Cited by 175 publications

(131 citation statements)

References 25 publications

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“…Third, only a few JNET Type 3 cases were included. Finally, this study did not include a comparison with other classification systems, such as the Sano, Hiroshima, Showa, and Jikei classifications [17][18][19][20] . In conclusion, the JNET classification is a valid tool for predicting the histology of localized colorectal lesions.…”

Section: Discussionmentioning

confidence: 99%

Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification

Komeda¹,

Kashida²,

Sakurai³

et al. 2017

Oncology

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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. 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

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Section: Discussionmentioning

confidence: 99%

Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification

Komeda¹,

Kashida²,

Sakurai³

et al. 2017

Oncology

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“…The applied light wavelengths are restricted to those specific to hemoglobin absorption, thereby clarifying mucosal vascular patterns. The NBI system was developed as an in vivo approach for visualizing the morphological changes in microvessels located in the superficial neoplasia or inflammation [16][17][18][19] . Endocytoscopic NBI (EC-NBI) is a new technique in which ultramagnified EC images are used in combination with NBI.…”

Section: Introductionmentioning

confidence: 99%

Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

Maeda¹,

Ohtsuka²,

Kudo³

et al. 2015

WJG

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AIM:To assess the efficacy of endocytoscopic narrowband imaging (EC-NBI) for evaluating the severity of inflammation in ulcerative colitis (UC). METHODS:This retrospective study was conducted at a single tertiary care referral center. We included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December 2013. EC-NBI was performed, and the images were evaluated by assessing visibility, increased vascularization, and the increased calibers of capillaries and were classified as Obscure, Visible or Dilated. Obscure was indicative of inactive disease, while Visible and Dilated were indicative of acute inflammation. This study received Institutional Review Board approval. The primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological activity. The conventional endoscopic images were classified according to the Mayo endoscopic score. A score of 0 or 1 indicated inactive disease, whereas a score of 2 indicated active disease. RESULTS:Fifty-two patients were enrolled. There was a strong correlation between the EC-NBI findings and the histological assessment (r = 0.871, P < 0.01).The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EC-NBI for diagnosing acute inflammation were 84.0%, 100%, 87.1%, 100%, and 92.3%, respectively, while those for the Mayo endoscopic score were 100%, 40.7%, and accuracy (P < 0.001, P = 0.001 and P = 0.047, respectively). CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.

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“…Based on the degree of dilatation of the capillary blood vessels and the appearance of the surface pattern revealed by the NBI (ME-NBI), there are reports from four facilities in Japan, including the NBI classification, which is recommended by our study (Table 2) [6][7][8][9][10][11]. The classifications listed by all four facilities suggest that the vascular pattern and histologic type/invasion depth of lesions are correlated.…”

Section: Discussion Based On the Vascular Pattern (Table 2)mentioning

confidence: 89%

Endoscopic features of submucosal deeply invasive colorectal cancer with NBI characteristics

Saito

Tajiri

Ikegami

2015

Clin J Gastroenterol

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In this review, we discuss the features of conventional endoscopy, magnified endoscopy involving image enhanced endoscopy and endoscopic ultrasonography (EUS) using illustrations for submucosal deeply invasive colorectal cancer (SM-Ca). First, the typical features of SM-Ca were observed, including fold convergence, stiffness, depression (ulceration) and elevated lesions in depressed areas. Magnified endoscopic findings using NBI showed dilated, irregularly shaped micro-capillary vessels. In addition, V I and V N pits were clearly visible using crystal violet staining. In contrast, using EUS, at the third layer we found a layer that was thin compared to the surrounding normal mucosa, which suggested the existence of SM-Ca.Keywords Submucosal invasive cancer Á Conventional endoscopy Á Magnified endoscopy Á Narrow band imaging (NBI) Á Autofluorescence imaging (AFI) Á Chromoendoscopy Á Endoscopic ultrasonography (EUS) Á High-frequency ultrasound probe (HFUP)

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Diagnosis of colorectal lesions with the magnifying narrow-band imaging system

Cited by 175 publications

References 25 publications

Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification

Magnifying Narrow Band Imaging (NBI) for the Diagnosis of Localized Colorectal Lesions Using the Japan NBI Expert Team (JNET) Classification

Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

Endoscopic features of submucosal deeply invasive colorectal cancer with NBI characteristics

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