Proposal of a new 'resect and discard' strategy using magnifying narrow band imaging

pilot study of diagnostic accuracy

Yoji Takeuchi, Masao Hanafusa, Hiromitsu Kanzaki, Takashi Ohta, Noboru Hanaoka

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

BACKGROUND AND AIM: A 'resect and discard' strategy using non-magnifying narrow band imaging (N-NBI) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI (M-NBI) that can potentially further improve the 'resect and discard' strategy. We conducted a pilot study to investigate the feasibility of M-NBI for the new 'resect and discard' strategy with consideration for advanced histology.

METHODS: The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N-NBI and M-NBI, a decision (discard or send for pathology) was made based on the M-NBI findings, and histological and optical diagnosis results were compared.

RESULTS: Sensitivity, specificity and accuracy (95% confidence interval) of M-NBI for lesions with advanced histology were 1.00 (0.36-1.00), 0.92 (0.91-0.92) and 0.92 (0.90-0.92), respectively. Whereas the management of 86% of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M-NBI. The diagnostic accuracy of M-NBI in distinguishing neoplastic from non-neoplastic lesions was higher than that of N-NBI.

CONCLUSIONS: We propose a new resect and discard strategy with advanced histology using M-NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.

Original languageEnglish
Pages (from-to)90-97
Number of pages8
JournalDigestive Endoscopy
Volume26
DOIs
Publication statusPublished - Apr 1 2014
Externally publishedYes

Fingerprint

Narrow Band Imaging
Histology
Polyps
Costs and Cost Analysis
Colonoscopy
Confidence Intervals
Pathology
Sensitivity and Specificity

Keywords

  • colon polyp surveillance
  • colonoscopy
  • colorectal neoplasm
  • narrow band imaging
  • resect and discard

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Proposal of a new 'resect and discard' strategy using magnifying narrow band imaging : pilot study of diagnostic accuracy. / Takeuchi, Yoji; Hanafusa, Masao; Kanzaki, Hiromitsu; Ohta, Takashi; Hanaoka, Noboru.

In: Digestive Endoscopy, Vol. 26, 01.04.2014, p. 90-97.

Research output: Contribution to journalArticle

@article{4e32c932b1b74d2394a36eaf79ee2489,
title = "Proposal of a new 'resect and discard' strategy using magnifying narrow band imaging: pilot study of diagnostic accuracy",
abstract = "BACKGROUND AND AIM: A 'resect and discard' strategy using non-magnifying narrow band imaging (N-NBI) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI (M-NBI) that can potentially further improve the 'resect and discard' strategy. We conducted a pilot study to investigate the feasibility of M-NBI for the new 'resect and discard' strategy with consideration for advanced histology.METHODS: The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N-NBI and M-NBI, a decision (discard or send for pathology) was made based on the M-NBI findings, and histological and optical diagnosis results were compared.RESULTS: Sensitivity, specificity and accuracy (95{\%} confidence interval) of M-NBI for lesions with advanced histology were 1.00 (0.36-1.00), 0.92 (0.91-0.92) and 0.92 (0.90-0.92), respectively. Whereas the management of 86{\%} of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M-NBI. The diagnostic accuracy of M-NBI in distinguishing neoplastic from non-neoplastic lesions was higher than that of N-NBI.CONCLUSIONS: We propose a new resect and discard strategy with advanced histology using M-NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.",
keywords = "colon polyp surveillance, colonoscopy, colorectal neoplasm, narrow band imaging, resect and discard",
author = "Yoji Takeuchi and Masao Hanafusa and Hiromitsu Kanzaki and Takashi Ohta and Noboru Hanaoka",
year = "2014",
month = "4",
day = "1",
doi = "10.1111/den.12248",
language = "English",
volume = "26",
pages = "90--97",
journal = "Digestive Endoscopy",
issn = "0915-5635",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Proposal of a new 'resect and discard' strategy using magnifying narrow band imaging

T2 - pilot study of diagnostic accuracy

AU - Takeuchi, Yoji

AU - Hanafusa, Masao

AU - Kanzaki, Hiromitsu

AU - Ohta, Takashi

AU - Hanaoka, Noboru

PY - 2014/4/1

Y1 - 2014/4/1

N2 - BACKGROUND AND AIM: A 'resect and discard' strategy using non-magnifying narrow band imaging (N-NBI) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI (M-NBI) that can potentially further improve the 'resect and discard' strategy. We conducted a pilot study to investigate the feasibility of M-NBI for the new 'resect and discard' strategy with consideration for advanced histology.METHODS: The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N-NBI and M-NBI, a decision (discard or send for pathology) was made based on the M-NBI findings, and histological and optical diagnosis results were compared.RESULTS: Sensitivity, specificity and accuracy (95% confidence interval) of M-NBI for lesions with advanced histology were 1.00 (0.36-1.00), 0.92 (0.91-0.92) and 0.92 (0.90-0.92), respectively. Whereas the management of 86% of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M-NBI. The diagnostic accuracy of M-NBI in distinguishing neoplastic from non-neoplastic lesions was higher than that of N-NBI.CONCLUSIONS: We propose a new resect and discard strategy with advanced histology using M-NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.

AB - BACKGROUND AND AIM: A 'resect and discard' strategy using non-magnifying narrow band imaging (N-NBI) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI (M-NBI) that can potentially further improve the 'resect and discard' strategy. We conducted a pilot study to investigate the feasibility of M-NBI for the new 'resect and discard' strategy with consideration for advanced histology.METHODS: The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N-NBI and M-NBI, a decision (discard or send for pathology) was made based on the M-NBI findings, and histological and optical diagnosis results were compared.RESULTS: Sensitivity, specificity and accuracy (95% confidence interval) of M-NBI for lesions with advanced histology were 1.00 (0.36-1.00), 0.92 (0.91-0.92) and 0.92 (0.90-0.92), respectively. Whereas the management of 86% of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M-NBI. The diagnostic accuracy of M-NBI in distinguishing neoplastic from non-neoplastic lesions was higher than that of N-NBI.CONCLUSIONS: We propose a new resect and discard strategy with advanced histology using M-NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.

KW - colon polyp surveillance

KW - colonoscopy

KW - colorectal neoplasm

KW - narrow band imaging

KW - resect and discard

UR - http://www.scopus.com/inward/record.url?scp=84925284835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925284835&partnerID=8YFLogxK

U2 - 10.1111/den.12248

DO - 10.1111/den.12248

M3 - Article

VL - 26

SP - 90

EP - 97

JO - Digestive Endoscopy

JF - Digestive Endoscopy

SN - 0915-5635

ER -