Observer Variability in Gastric Neoplasm Assessment Using the Vessel Plus Surface Classification for Magnifying Endoscopy with Narrow Band Imaging
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Recent studies have demonstrated that magnifying endoscopy with narrow band imaging (ME-NBI) facilitates differentiation of early gastric cancer from gastric adenoma using vessel plus surface (VS) classification. This study estimated the interobserver and intraobserver agreement of endoscopists using the Yao VS classification system for the gastric mucosal surface. Methods: We retrospectively reviewed patients who underwent endoscopic submucosal dissection or endoscopic mucosal resection, and selected cases in which preoperative ME-NBI was conducted. Before testing endoscopists, a 20-minute training module was given. Static ME-NBI images (n= 47 cases) were presented to seven endoscopists (two experts and five trainees) who were asked to assess the images in 20 seconds using the Yao VS classification system. After 2 weeks, the endoscopists were asked to analyze the images again. The κ statistic was calculated for intraobserver and interobserver variability. Results: The mean κ for intraobserver agreement was 0.69 (experts, 0.74; trainees, 0.64). The mean κ for interobserver agreement was 0.42 (experts, 0.49; trainees, 0.40). Conclusions: We obtained reliable results as assessed by observer variability, with only brief training on VS classification. The VS classification appears to provide an objective assessment of ME-NBI for trainees who are not familiar with ME-NBI.
Abstract
Background/Aims: Recent studies have demonstrated that magnifying endoscopy with narrow band imaging (ME-NBI) facilitates differentiation of early gastric cancer from gastric adenoma using vessel plus surface (VS) classification. This study estimated the interobserver and intraobserver agreement of endoscopists using the Yao VS classification system for the gastric mucosal surface. Methods: We retrospectively reviewed patients who underwent endoscopic submucosal dissection or endoscopic mucosal resection, and selected cases in which preoperative ME-NBI was conducted. Before testing endoscopists, a 20-minute training module was given. Static ME-NBI images (n= 47 cases) were presented to seven endoscopists (two experts and five trainees) who were asked to assess the images in 20 seconds using the Yao VS classification system. After 2 weeks, the endoscopists were asked to analyze the images again. The κ statistic was calculated for intraobserver and interobserver variability. Results: The mean κ for intraobserver agreement was 0.69 (experts, 0.74; trainees, 0.64). The mean κ for interobserver agreement was 0.42 (experts, 0.49; trainees, 0.40). Conclusions: We obtained reliable results as assessed by observer variability, with only brief training on VS classification. The VS classification appears to provide an objective assessment of ME-NBI for trainees who are not familiar with ME-NBI.
참고문헌 (15)
- Miwa K, "Can magnifying endoscopy with narrow band imaging be useful for low grade adenomas in preoperative biopsy specimens?", Gastric Cancer, 15, pp.170~178 (2012)
- Yao K, "How is the VS (vessel plus surface) classification system applicable to magnifying narrow-band imaging examinations of gastric neoplasias initially diagnosed as low-grade adenomas?", Gastric Cancer, 15, pp.118~120 (2012)
- Gono K, "Appearance of enhanced tissue features in narrow-band endoscopic imaging", J Biomed Opt, 9, pp.568~577 (2004)
- Nakayoshi T, "Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video)", Endoscopy, 36, pp.1080~1084 (2004)
- Yao K, "White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma", Gastrointest Endosc, 68, pp.574~580 (2008)
- Tsuji Y, "Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas", Gastric Cancer, 15, pp.414~418 (2012)
- Yao K, "Magnifying endoscopy for diagnosing and delineating early gastric cancer", Endoscopy, 41, pp.462~467 (2009)
- Schlemper RJ, "The Vienna classification of gastrointestinal epithelial neoplasia", Gut, 47, pp.251~255 (2000)
- Viera AJ, "Understanding interobserver agreement: the kappa statistic", Fam Med, 37, pp.360~363 (2005)
- Kim YJ, "Histologic diagnosis based on forceps biopsy is not adequate for determining endoscopic treatment of gastric adenomatous lesions", Endoscopy, 42, pp.620~626 (2010)
- Yao K, "Novel zoom endoscopy technique for diagnosis of small flat gastric cancer: a prospective, blind study", Clin Gastroenterol Hepatol, 5, pp.869~878 (2007)
- Kaise M, "Magnifying endoscopy combined with narrow-band imaging for differential diagnosis of superficial depressed gastric lesions", Endoscopy, 41, pp.310~315 (2009)
- Miwa H, "Interobserver agreement in endoscopic evaluation of reflux esophagitis using a modified Los Angeles classification incorporating grades N and M: a validation study in a cohort of Japanese endoscopists", Dis Esophagus, 21, pp.355~363 (2008)
- Nasseri-Moghaddam S, "Inter- and intra-observer variability of the Los Angeles classification: a reassessment", Arch Iran Med, 10, pp.48~53 (2007)
- Ezoe Y, "Magnifying narrowband imaging is more accurate than conventional white-light imaging in diagnosis of gastric mucosal cancer", Gastroenterology, 141, pp.2017~2025 (2011)