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- Title
Combining Autofluorescence Imaging and Narrow-Band Imaging for the Differentiation of Adenomas from Non-Neoplastic Colonic Polyps Among Experienced and Non-Experienced Endoscopists.
- Authors
van den Broek, Frank J. C.; van Soest, Ellert J.; Naber, Anton H.; van Oijen, Arnoud H. A. M.; Mallant-Hent, Rosalie Ch.; Böhmer, Clarisse J. M.; Scholten, Pieter; Stokkers, Pieter C. F.; Marsman, Willem A.; Mathus-Vliegen, Elisabeth M. H.; Curvers, Wouter L.; Bergman, Jacques J. G. H. M.; van Eeden, Susanne; Hardwick, James C. H.; Fockens, Paul; Reitsma, Johannes B.; Dekker, Evelien
- Abstract
OBJECTIVES:Endoscopic tri-modal imaging incorporates high-resolution white-light endoscopy (HR-WLE), narrow-band imaging (NBI), and autofluorescence imaging (AFI). Combining these advanced techniques may improve endoscopic differentiation between adenomas and non-neoplastic polyps. In this study, we aimed to assess the interobserver variability and accuracy of HR-WLE, NBI, and AFI for polyp differentiation and to evaluate the combined use of AFI and NBI.METHODS:First, still images of 50 polyps (22 adenomas; median 3 mm) were randomly displayed to three experienced and four non-experienced endoscopists. All HR-WLE and NBI images were scored for Kudo classification and AFI images for color. Second, the combined AFI and NBI images were assessed using a newly developed algorithm by six additional non-experienced endoscopists.RESULTS:The outcomes measured were interobserver agreement and diagnostic accuracy using histopathology as reference standard. Experienced endoscopists had better interobserver agreement for NBI (κ=0.77) than for AFI (κ=0.33), whereas non-experienced endoscopists had better agreement for AFI (κ=0.58) than for NBI (κ=0.33). The accuracies of HR-WLE, NBI, and AFI among experienced endoscopists were 65, 70, and 74, respectively. Figures among non-experienced endoscopists were 57, 63, and 77. The algorithm was associated with a significantly higher accuracy of 85% among all observers (P<0.023). These figures were confirmed in the second evaluation study.CONCLUSIONS:Non-experienced endoscopists have better interobserver agreement and accuracy for AFI than for HR-WLE or NBI, indicating that AFI is easier to use for polyp differentiation in non-experienced setting. The newly developed algorithm, combining information of AFI and NBI together, had the highest accuracy and obtained equal results between experienced and non-experienced endoscopists.Am J Gastroenterol 2009; 104:1498–1507; doi:10.1038/ajg.2009.161; published online 28 April 2009
- Subjects
MEDICAL imaging systems; ADENOMA; POLYPS; ENDOSCOPY; GASTROENTEROLOGY
- Publication
American Journal of Gastroenterology (Springer Nature), 2009, Vol 104, Issue 6, p1498
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1038/ajg.2009.161