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Feasibility of a simplified narrow-band imaging classification system for Barrett’s esophagus for novice endoscopists
摘要： Background Narrow-band imaging (NBI) classifications for Barrett’s esophagus have been proposed for the detection of early esophageal adenocarcinoma. We developed a simplified classification system with demonstrated high diagnostic accuracy and reproducibility among experienced endoscopists, but the feasibility of this system among novice endoscopists was unclear. Methods In the present study, eight novice endoscopists with no experience of magnification endoscopy were asked to review 248 images of Barrett’s esophagus (72 dysplastic, 176 non-dysplastic) obtained using high-definition magnification endoscopy with NBI 6 weeks before (1st test), immediately after (2nd test), and 6 weeks after (3rd test) being taught the simplified classification system. The primary outcomes were differences in diagnostic accuracy for dysplasia among the three tests. Results The specificity and overall accuracy improved significantly in the 2nd vs. 1st test [97% vs. 80% (p < 0.001) and 94% vs. 82% (p < 0.001), respectively], sensitivity was comparable (87% in both tests; p = 0.42). In the 3rd test, the sensitivity and overall accuracy decreased significantly compared with the 2nd test [82% vs. 87% (p < 0.001) and 93% vs. 94% (p < 0.05), respectively], but there was no significant difference in specificity (97% in both tests; p = 0.16). The kappa values for interobserver agreement for the mucosal pattern, vascular pattern, and predicted histology were substantial, and improved significantly in the 2nd vs. 1st test (0.78 vs. 0.59, 0.70 vs. 0.53, and 0.79 vs. 0.66, respectively; p < 0.001 for all). Conclusions The simplified NBI classification system may be appropriate for novice endoscopists to use in providing high accuracy and reproducibility.
关键词： Narrow-band imaging,Magnification endoscopy,Barrett’s esophagus,Classification,Esophageal adenocarcinoma
更新于2025-09-23 15:23:52
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High-Resolution ENT Video Endoscope with Superior Image Quality Equivalent to that of Gastric Video Endoscopes
摘要： Background and study aims: To assess the usability of high resolution fiberscope which has equivalent image quality to that of the esophageal and gastric video endoscopes. Patients and methods: Image resolution of this endoscope was estimated by the United States Air Force (USAF) resolution test chart. Clinical application was done between January and December 2010 and transnasal observation of the larynx and hypopharynx were performed during this period. These examinations were done for screening and follow-up for patients with hypopharyngeal and laryngeal disorders. Results: This endoscope could distinguish features on a scale of nearly 20 μm, and abnormal vascular patterns on the mucosal surface characteristic of carcinomas were clearly observed under a conventional light source. In addition, these changes on the mucosal surface became more apparent with use of the i-SCAN?. Nevertheless, the handling of this video endoscope was similar to that of popular ENT video endoscopes, and all patients tolerated its use well. Conclusion: This new device may dramatically improve pharyngolaryngeal examination in ENT clinics.
关键词： Narrow-band imaging,Intraepithelial papillary capillary loops,Early diagnosis,Video endoscope
更新于2025-09-23 15:22:29
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Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome: a randomized controlled trial with tandem colonoscopy
摘要： Background: It is unknown whether narrow-band imaging (NBI) could be more effective than high-definition white-light endoscopy (HD-WLE) in detecting serrated lesions in patients with prior serrated lesions > 5 mm not completely fulfilling serrated polyposis syndrome (SPS) criteria. Methods: We conducted a randomized, cross-over trial in consecutive patients with prior detection of at least one serrated polyp ≥10 mm or ≥ 3 serrated polyps larger than 5 mm, both proximal to the sigmoid colon. Five experienced endoscopists performed same-day tandem colonoscopies, with the order being randomized 1:1 to NBI—HD-WLE or HD-WLE—NBI. All tandem colonoscopies were performed by the same endoscopist. Results: We included 41 patients. Baseline characteristics were similar in the two cohorts: NBI—HD-WLE (n = 21) and HD-WLE—NBI (n = 20). No differences were observed in the serrated lesion detection rate of NBI versus HD-WLE: 47.4% versus 51.9% (OR 0.84, 95% CI: 0.37–1.91) for the first and second withdrawal, respectively. Equally, no differences were found in the polyp miss rate of NBI versus HD-WLE: 21.3% versus 26.1% (OR 0.77, 95% CI: 0.43–1.38). Follow-up colonoscopy in nine patients (22%) allowed them to be reclassified as having SPS. Conclusions: In patients with previous serrated lesions, the serrated lesion detection rate was similar with NBI and HD-WLE. A shorter surveillance colonoscopy interval increases the detection of missed serrated polyps and could change the diagnosis of SPS in approximately one in every five patients.
关键词： Colonoscopy,Optical imaging,Narrow-band imaging,Colonic polyps
更新于2025-09-23 15:19:57
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Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery
摘要： Purpose Flexible transnasal endoscopy is a common examination technique for the evaluation of laryngeal lesions, while the use of narrow band imaging (NBI) has been reported to enhance the diagnostic value of white light endoscopy (WLE). The purpose of this study is to assess observer variability and diagnostic value of both modalities and investigate the possible influence of previous laryngeal surgery on the detection rates of laryngeal malignancy. Methods The study was based on the retrospective evaluation of 170 WLE and NBI images of laryngeal lesions by three observers in a random order. The histopathological diagnoses serve as the gold standard. Results In identifying laryngeal malignancy, the sensitivity of NBI proved to be higher than that of WLE (93.3% vs. 77.0%). NBI was also superior to WLE in terms of accuracy (96.3% vs. 92%) and diagnostic odds ratio (501.83 vs. 120.65). Both modalities had a specificity of 97.3%. The inter-observer agreement was substantial (kappa = 0.661) for WLE and almost perfect (kappa = 0.849) for NBI. Both WLE and NBI showed a high level of intra-observer agreement. The sensitivity was significantly lower in images with history of previous laryngeal surgery compared to those without. Conclusions Flexible transnasal endoscopy has been proved to be a valuable tool in the diagnosis of laryngeal malignancy. The use of NBI can increase the sensitivity and observer reliability in that context and can also provide a diagnostic gain in cases with previous laryngeal surgery
关键词： Observer reliability,Narrow band imaging,Laryngeal endoscopy,Laryngeal cancer
更新于2025-09-23 15:19:57
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Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging
摘要： Objective early detection of gastric cancer has been the topic of major efforts in high prevalence areas. Whether advanced imaging methods, such as second-generation narrow band imaging (2g- nBi) can improve early detection, is unknown. Design This open-label, randomised, controlled tandem trial was conducted in 13 hospitals. Patients at increased risk for gastric cancer were randomly assigned to primary white light imaging (Wli) followed by secondary 2g- nBi (Wli group: n=2258) and primary 2g- nBi followed by secondary Wli (2g- nBi group: n=2265) performed by the same examiner. suspected early gastric cancer (egc) lesions in both groups were biopsied. Primary endpoint was the rate of egc patients in the primary examination. The main secondary endpoint was the positive predictive value (PPV) for egc in suspicious lesions detected (primary examination). results egcs were found in 44 (1.9%) and 53 (2.3%; p=0.412) patients in the Wli and 2g- nBi groups, respectively, during primary egD. in a post hoc analysis, the overall rate of lesions detected at the second examination was 25% (n=36/145), with no significant differences between groups. PPV for egc in suspicious lesions was 13.5% and 20.9% in the Wli (50/371 target lesions) and 2g- nBi groups (59/282 target lesions), respectively (p=0.015). Conclusion The overall sensitivity of primary endoscopy for the detection of egc in high- risk patients was only 75% and should be improved. 2g- nBi did not increase egc detection rate over conventional Wli. The impact of a slightly better PPV of 2g- nBi has to be evaluated further.
关键词： positive predictive value,narrow band imaging,early gastric cancer,detection rate,white light imaging
更新于2025-09-19 17:13:59
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Computer-assisted diagnosis of early esophageal squamous cell carcinoma using narrow-band imaging magnifying endoscopy
摘要： Background We developed a computer-assisted diagnosis model to evaluate the feasibility of automated classification of intrapapillary capillary loops (IPCLs) to improve the detection of esophageal squamous cell carcinoma (ESCC). Methods We recruited patients who underwent magnifying endoscopy with narrow-band imaging for evaluation of a suspicious esophageal condition. Case images were evaluated to establish a gold standard IPCL classification according to the endoscopic diagnosis and histological findings. A double-labeling fully convolutional network (FCN) was developed for image segmentation. Diagnostic performance of the model was compared with that of endoscopists grouped according to years of experience (senior > 15 years; mid level 10 – 15 years; junior 5 – 10 years). Results Of the 1383 lesions in the study, the mean accuracies of IPCL classification were 92.0 %, 82.0 %, and 73.3 %, for the senior, mid level, and junior groups, respectively. The mean diagnostic accuracy of the model was 89.2 % and 93.0 % at the lesion and pixel levels, respectively. The interobserver agreement between the model and the gold standard was substantial (kappa value, 0.719). The accuracy of the model for inflammatory lesions (92.5 %) was superior to that of the mid level (88.1 %) and junior (86.3 %) groups (P < 0.001). For malignant lesions, the accuracy of the model (B1, 87.6 %; B2, 93.9 %) was significantly higher than that of the mid level (B1, 79.1 %; B2, 90.0 %) and junior (B1, 69.2 %; B2, 79.3 %) groups (P < 0.001). Conclusions Double-labeling FCN automated IPCL recognition was feasible and could facilitate early detection of ESCC.
关键词： esophageal squamous cell carcinoma,intrapapillary capillary loops,computer-assisted diagnosis,narrow-band imaging,magnifying endoscopy
更新于2025-09-10 09:29:36