본문 바로가기
KERD
논문KCI 등재

Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류내과학

초록

Background/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow-band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm). Methods: This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology. Results: There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001). Conclusions: NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

Abstract

Background/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow-band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm). Methods: This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology. Results: There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001). Conclusions: NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

참고문헌 (22)

  1. Winawer SJ, "Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup", N Engl J Med, 328, pp.901~906 (1993)
  2. Zauber AG, "Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths", N Engl J Med, 366, pp.687~696 (2012)
  3. Ponugoti PL, "Risk of cancer in small and diminutive colorectal polyps", Dig Liver Dis, 49, pp.34~37 (2017)
  4. Iwatate M, "NBI and NBI combined with magnifying colonoscopy", Diagn Ther Endosc, 2012, pp.173269~ (2012)
  5. Hewett DG, "Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging", Gastroenterology, 143, pp.599~607 (2012)
  6. Ciocâlteu AM, "Narrow band imaging with near-focus mode for colorectal polyps’ characterization", Rom J Morphol Embryol, 57(2 Suppl), pp.619~626 (2016)
  7. Iwatate M, "The addition of high magnifying endoscopy improves rates of high confidence optical diagnosis of colorectal polyps", Endosc Int Open, 3, pp.E140~ (2015)
  8. Ikematsu H, "Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps", Surg Endosc, 29, pp.844~850 (2015)
  9. Rex DK, "Narrow-band imaging without optical magnification for histologic analysis of colorectal polyps", Gastroenterology, 136, pp.1174~1181 (2009)
  10. Rastogi A, "High accuracy of narrow band imaging without magnification for the real-time characterization of polyp histology and its comparison with high-definition white light colonoscopy : a prospective study", Am J Gastroenterol, 104, pp.2422~2430 (2009)
  11. Chiu HM, "A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia", Gut, 56, pp.373~379 (2007)
  12. Kuruvilla N, "A prospective dual-center proof-of-principle study evaluating the incremental benefit of narrow-band imaging with a fixed zoom function in real-time prediction of polyp histology : can we resect and discard?", Gastrointest Endosc, 82, pp.362~369 (2015)
  13. The Paris endoscopic classification of superficial neoplastic lesions, "esophagus, stomach, and colon : November 30 to December 1, 2002", Gastrointest Endosc, 58(6 Suppl), pp.S3~S43 (2003)
  14. Singh R, "Is narrow band imaging superior to high-definition white light endoscopy in the assessment of diminutive colorectal polyps?", J Gastroenterol Hepatol, 28, pp.472~478 (2013)
  15. Nagtegaal ID, "The 2019 WHO classification of tumours of the digestive system", Histopathology, 76, pp.182~188 (2020)
  16. McGill SK, "Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time : a meta-analysis of diagnostic operating characteristics", Gut, 62, pp.1704~1713 (2013)
  17. Kaltenbach T, "Real-time optical diagnosis for diminutive colorectal polyps using narrow-band imaging : the VALID randomised clinical trial", Gut, 64, pp.1569~1577 (2015)
  18. Hattori S, "Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions", World J Gastrointest Endosc, 6, pp.600~605 (2014)
  19. Szura M, "Two-stage optical system for colorectal polyp assessments", Surg Endosc, 30, pp.204~214 (2016)
  20. Wallace MB, "Accuracy of in vivo colorectal polyp discrimination by using dual-focus high-definition narrow-band imaging colonoscopy", Gastrointest Endosc, 80, pp.1072~1087 (2014)
  21. Singh R, "Narrow-band imaging with dual focus magnification in differentiating colorectal neoplasia", Dig Endosc, 25(Suppl 2), pp.16~20 (2013)
  22. Higashi R, "Diagnostic accuracy of narrow-band imaging and pit pattern analysis significantly improved for less-experienced endoscopists after an expanded training program", Gastrointest Endosc, 72, pp.127~135 (2010)

관련 논문AI추천

Polyp Detection, Characterization, and Management Using Narrow-Band Imaging with/without MagnificationHironori Sunakawa, Mineo Iwatate, Noriaki Hasuike, Santa Hattori, Takahiro Utsumi, Wataru Sano, Yasushi Sano대한소화기내시경학회 · Clinical Endoscopy2015 · 제48권 제6호Optical Diagnosis for Colorectal Polyps: A Useful Technique Now or in the Future?Ignasi Puig, Tonya Kaltenbach거트앤리버 소화기연관학회협의회 · Gut and Liver2018 · 제12권 제4호Optical diagnosis by near-focus versus normal-focus narrow band imaging colonoscopy in colorectal polyps based on combined NICE and WASP classification: a randomized controlled trialBancha Ovartlarnporn, Jaksin Sottisuporn, Kanet Kanjanapradit, Natcha Cheewasereechon, Nisa Netinatsunton, Tanawat Pattarapuntakul대한소화기내시경학회 · Clinical Endoscopy2022 · 제55권 제5호Comparative Study of Narrow-Band Imaging and i-scan for Predicting the Histology of Intermediate-to-Large Colorectal Polyps: A Prospective, Randomized Pilot StudyJoon Seop Lee, Seong Woo Jeon, Yong Hwan Kwon대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제6호Optical Diagnosis of Small Colorectal Polyp Histology with High-Definition Colonoscopy Using Narrow Band Imaging.Amit Rastogi대한소화기내시경학회 · Clinical Endoscopy2013 · 제46권 제2호Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trialsFumiaki Ishibashi, Ken Ohata, Kentaro Mochida, Mizuki Nagai, Sho Suzuki, Tetsuo Morishita, Yohei Minato대한소화기내시경학회 · Clinical Endoscopy2023 · 제56권 제5호

이 간행물의 다른 논문 (17건)