Mineo Iwatate1, Yasushi Sano1, Shinji Tanaka2, Shin-Ei Kudo3, Shoichi Saito4, Takahisa Matsuda5, Yoshiki Wada6, Takahiro Fujii7, Hiroaki Ikematsu8, Toshio Uraoka9, Nozomu Kobayashi10, Hisashi Nakamura11, Kinichi Hotta12, Takahiro Horimatsu13, Naoto Sakamoto14, Kuang-I Fu15, Osamu Tsuruta16, Hiroshi Kawano17, Hiroshi Kashida18, Yoji Takeuchi19, Hirohisa Machida20, Toshihiro Kusaka21, Naohisa Yoshida22, Ichiro Hirata23, Takeshi Terai24, Hiro-O Yamano25, Takeshi Nakajima26, Taku Sakamoto26, Yuichiro Yamaguchi27, Naoto Tamai28, Naoko Nakano29, Nana Hayashi2, Shiro Oka2, Hideki Ishikawa30, Yoshitaka Murakami31, Shigeaki Yoshida32, Yutaka Saito26. 1. Gasrtrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan. 2. Department of Endoscopy, Hiroshima University, Hiroshima, Japan. 3. Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. 4. Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan. 5. Cancer Screening Center, Tokyo, Japan. 6. Wada Clinic, Wakayama, Japan. 7. Takahiro Fujii Clinic, Tokyo, Japan. 8. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan. 9. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan. 10. Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan. 11. Akasaka Endoscopic Clinic, Tokyo, Japan. 12. Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Japan. 13. Department of Therapeutic Oncology, Kyoto University, Kyoto, Japan. 14. Department of Gastroenterology, Juntendo University, Tokyo, Japan. 15. Department of Gastroenterology, Kanma Memorial Hospital, Nasushiobara, Japan. 16. Division of Gastroenterology, Kurume University, Kurume, Japan. 17. Department of Gastroenterology, St. Mary's Hospital, Kurume, Japan. 18. Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Japan. 19. Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan. 20. Internal Medicine, Machida Gastrointestinal Hospital, Osaka, Japan. 21. Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan. 22. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan. 23. Department of Gastroenterology, Osaka Central Hospital, Osaka, Japan. 24. Terai Clinic, Tokyo, Japan. 25. Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan. 26. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. 27. Tokura Yamaguchi Clinic, Mishima, Japan. 28. Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. 29. Department of Gastroenterology, Fujita Health University, Toyoake, Japan. 30. Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan. 31. Toho University, Tokyo, Japan. 32. CEO, Aomori Prefectural Central Hospital Administration, Aomori, Japan.
Abstract
BACKGROUND AND AIM: The Japan narrow-band imaging (NBI) Expert Team (JNET) was organized to unify four previous magnifying NBI classifications (the Sano, Hiroshima, Showa, and Jikei classifications). The JNET working group created criteria (referred to as the NBI scale) for evaluation of vessel pattern (VP) and surface pattern (SP). We conducted a multicenter validation study of the NBI scale to develop the JNET classification of colorectal lesions. METHODS: Twenty-five expert JNET colonoscopists read 100 still NBI images with and without magnification on the web to evaluate the NBI findings and necessity of the each criterion for the final diagnosis. RESULTS: Surface pattern in magnifying NBI images was necessary for diagnosis of polyps in more than 60% of cases, whereas VP was required in around 90%. Univariate/multivariate analysis of candidate findings in the NBI scale identified three for type 2B (variable caliber of vessels, irregular distribution of vessels, and irregular or obscure surface pattern), and three for type 3 (loose vessel area, interruption of thick vessel, and amorphous areas of surface pattern). Evaluation of the diagnostic performance for these three findings in combination showed that the sensitivity for types 2B and 3 was highest (44.9% and 54.7%, respectively), and that the specificity for type 3 was acceptable (97.4%) when any one of the three findings was evident. We found that the macroscopic type (polypoid or non-polypoid) had a minor influence on the key diagnostic performance for types 2B and 3. CONCLUSION: Based on the present data, we reached a consensus for developing the JNET classification.
BACKGROUND AND AIM: The Japan narrow-band imaging (NBI) Expert Team (JNET) was organized to unify four previous magnifying NBI classifications (the Sano, Hiroshima, Showa, and Jikei classifications). The JNET working group created criteria (referred to as the NBI scale) for evaluation of vessel pattern (VP) and surface pattern (SP). We conducted a multicenter validation study of the NBI scale to develop the JNET classification of colorectal lesions. METHODS: Twenty-five expert JNET colonoscopists read 100 still NBI images with and without magnification on the web to evaluate the NBI findings and necessity of the each criterion for the final diagnosis. RESULTS: Surface pattern in magnifying NBI images was necessary for diagnosis of polyps in more than 60% of cases, whereas VP was required in around 90%. Univariate/multivariate analysis of candidate findings in the NBI scale identified three for type 2B (variable caliber of vessels, irregular distribution of vessels, and irregular or obscure surface pattern), and three for type 3 (loose vessel area, interruption of thick vessel, and amorphous areas of surface pattern). Evaluation of the diagnostic performance for these three findings in combination showed that the sensitivity for types 2B and 3 was highest (44.9% and 54.7%, respectively), and that the specificity for type 3 was acceptable (97.4%) when any one of the three findings was evident. We found that the macroscopic type (polypoid or non-polypoid) had a minor influence on the key diagnostic performance for types 2B and 3. CONCLUSION: Based on the present data, we reached a consensus for developing the JNET classification.
Authors: Tiing Leong Ang; Jit Fong Lim; Tju Siang Chua; Kok Yang Tan; James Weiquan Li; Chern Hao Chong; Kok Ann Gwee; Vikneswaran S/O Namasivayam; Charles Kien Fong Vu; Christopher Jen Lock Khor; Lai Mun Wang; Khay Guan Yeoh Journal: Singapore Med J Date: 2020-07-16 Impact factor: 3.331
Authors: Chan Hyuk Park; Dong-Hoon Yang; Jong Wook Kim; Jie-Hyun Kim; Ji Hyun Kim; Yang Won Min; Si Hyung Lee; Jung Ho Bae; Hyunsoo Chung; Kee Don Choi; Jun Chul Park; Hyuk Lee; Min-Seob Kwak; Bun Kim; Hyun Jung Lee; Hye Seung Lee; Miyoung Choi; Dong-Ah Park; Jong Yeul Lee; Jeong-Sik Byeon; Chan Guk Park; Joo Young Cho; Soo Teik Lee; Hoon Jai Chun Journal: Intest Res Date: 2020-10-13