Validation study for development of the Japan NBI Expert Team classification of colorectal lesions
Corresponding Author
Mineo Iwatate
Gasrtrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan
Corresponding: Mineo Iwatate, Gastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, 2-5-1 Shimizugaoka, Tarumi-ku, Kobe, Hyogo 655-0031, Japan. Email: [email protected]Search for more papers by this authorYasushi Sano
Gasrtrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan
Search for more papers by this authorShinji Tanaka
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorShin-ei Kudo
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
Search for more papers by this authorShoichi Saito
Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
Search for more papers by this authorHiroaki Ikematsu
Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
Search for more papers by this authorToshio Uraoka
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
Search for more papers by this authorNozomu Kobayashi
Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
Search for more papers by this authorKinichi Hotta
Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Japan
Search for more papers by this authorTakahiro Horimatsu
Department of Therapeutic Oncology, Kyoto University, Kyoto, Japan
Search for more papers by this authorNaoto Sakamoto
Department of Gastroenterology, Juntendo University, Tokyo, Japan
Search for more papers by this authorKuang-I Fu
Department of Gastroenterology, Kanma Memorial Hospital, Nasushiobara, Japan
Search for more papers by this authorOsamu Tsuruta
Division of Gastroenterology, Kurume University, Kurume, Japan
Search for more papers by this authorHiroshi Kawano
Department of Gastroenterology, St. Mary's Hospital, Kurume, Japan
Search for more papers by this authorHiroshi Kashida
Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Japan
Search for more papers by this authorYoji Takeuchi
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorHirohisa Machida
Internal Medicine, Machida Gastrointestinal Hospital, Osaka, Japan
Search for more papers by this authorToshihiro Kusaka
Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
Search for more papers by this authorNaohisa Yoshida
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan
Search for more papers by this authorIchiro Hirata
Department of Gastroenterology, Osaka Central Hospital, Osaka, Japan
Search for more papers by this authorHiro-o Yamano
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
Search for more papers by this authorTakeshi Nakajima
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorTaku Sakamoto
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorNaoto Tamai
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
Search for more papers by this authorNaoko Nakano
Department of Gastroenterology, Fujita Health University, Toyoake, Japan
Search for more papers by this authorNana Hayashi
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorShiro Oka
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorHideki Ishikawa
Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
Search for more papers by this authorShigeaki Yoshida
CEO, Aomori Prefectural Central Hospital Administration, Aomori, Japan
Search for more papers by this authorYutaka Saito
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorThe Japan NBI Expert Team (JNET)
Search for more papers by this authorCorresponding Author
Mineo Iwatate
Gasrtrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan
Corresponding: Mineo Iwatate, Gastrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, 2-5-1 Shimizugaoka, Tarumi-ku, Kobe, Hyogo 655-0031, Japan. Email: [email protected]Search for more papers by this authorYasushi Sano
Gasrtrointestinal Center and Institute of Minimally-Invasive Endoscopic Care (iMEC), Sano Hospital, Kobe, Japan
Search for more papers by this authorShinji Tanaka
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorShin-ei Kudo
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
Search for more papers by this authorShoichi Saito
Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
Search for more papers by this authorHiroaki Ikematsu
Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
Search for more papers by this authorToshio Uraoka
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
Search for more papers by this authorNozomu Kobayashi
Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
Search for more papers by this authorKinichi Hotta
Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Japan
Search for more papers by this authorTakahiro Horimatsu
Department of Therapeutic Oncology, Kyoto University, Kyoto, Japan
Search for more papers by this authorNaoto Sakamoto
Department of Gastroenterology, Juntendo University, Tokyo, Japan
Search for more papers by this authorKuang-I Fu
Department of Gastroenterology, Kanma Memorial Hospital, Nasushiobara, Japan
Search for more papers by this authorOsamu Tsuruta
Division of Gastroenterology, Kurume University, Kurume, Japan
Search for more papers by this authorHiroshi Kawano
Department of Gastroenterology, St. Mary's Hospital, Kurume, Japan
Search for more papers by this authorHiroshi Kashida
Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Japan
Search for more papers by this authorYoji Takeuchi
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
Search for more papers by this authorHirohisa Machida
Internal Medicine, Machida Gastrointestinal Hospital, Osaka, Japan
Search for more papers by this authorToshihiro Kusaka
Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
Search for more papers by this authorNaohisa Yoshida
Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan
Search for more papers by this authorIchiro Hirata
Department of Gastroenterology, Osaka Central Hospital, Osaka, Japan
Search for more papers by this authorHiro-o Yamano
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
Search for more papers by this authorTakeshi Nakajima
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorTaku Sakamoto
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorNaoto Tamai
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
Search for more papers by this authorNaoko Nakano
Department of Gastroenterology, Fujita Health University, Toyoake, Japan
Search for more papers by this authorNana Hayashi
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorShiro Oka
Department of Endoscopy, Hiroshima University, Hiroshima, Japan
Search for more papers by this authorHideki Ishikawa
Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
Search for more papers by this authorShigeaki Yoshida
CEO, Aomori Prefectural Central Hospital Administration, Aomori, Japan
Search for more papers by this authorYutaka Saito
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
Search for more papers by this authorThe Japan NBI Expert Team (JNET)
Search for more papers by this authorAbstract
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.
Conflicts of Interest
Authors declare no conflicts of interest for this article.
Supporting Information
| Filename | Description |
|---|---|
| den13065-sup-0001-FigS1.TIFimage/tif, 326.2 KB | Figure S1 Color criterion based on the NICE classification. |
| den13065-sup-0002-TableS1-S5.docxWord document, 18.8 KB |
Table S1 Prevalence and univariate/multivariate analysis of the five candidate type 3 findings for D-SMC. Table S2 Performance characteristics for combinations of three type 3 findings predictive of D-SMC. Table S3 Prevalence and univariate/multivariate analysis of the five candidate type 2B findings for submucosal invasive cancer and HGIN. Table S4 Performance characteristics for combinations of four and three type 2B findings predictive of submucosal invasive cancer and HGIN. Table S5 Diagnostic performance of type 2B and 3 findings predictive of corresponding histopathology for polypoid and non-polypoid type. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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