Reference : Pit pattern analysis with high-definition chromoendoscopy and narrow-band imaging for...
Scientific journals : Article
Human health sciences : Gastroenterology & hepatology
http://hdl.handle.net/2268/225153
Pit pattern analysis with high-definition chromoendoscopy and narrow-band imaging for optical diagnosis of dysplasia in patients with ulcerative colitis
English
Bisschops, R. [Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium]
Bessissow, T. [Division of Gastroenterology, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada]
Dekker, E. [Department of Gastroenterology and Hepatology, Amsterdam Medical Center, Amsterdam, Netherlands]
East, J. E. [Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom]
Para-Blanco, A. [NIHR Nottingham Digestive Diseases Biomedical Research Unit City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom]
Ragunath, K. [NIHR Nottingham Digestive Diseases Biomedical Research Unit City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom]
Bhandari, P. [Department of Gastroenterology, Spire Portsmouth Hospital, Portsmouth, United Kingdom]
Rutter, M. [Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, Cleveland, United Kingdom School of Medicine, Durham University, Durham, United Kingdom]
Schoon, E. [Department of Gastroenterology, Catherina Hospital, Eindhoven, Netherlands]
Wilson, A. [Wolfson Unit for Endoscopy, St. Mark's Hospital, London, United Kingdom]
John, J. M. [Medical Genomics Unit, BIO3, GIGA-R, University of Liège, Liège, Belgium]
Van Steen, Kristel mailto [Université de Liège - ULiège > Dép. d'électric., électron. et informat. (Inst.Montefiore) > Bioinformatique >]
Baert, F. [Department of Gastroenterology, AZ Delta, Roeselare, Belgium]
Ferrante, M. [Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium]
2017
Gastrointestinal Endoscopy
Mosby Inc.
86
6
1100-1106.e1
Yes (verified by ORBi)
International
0016-5107
1097-6779
[en] Article ; Kudo pit pattern classification
[en] Background and Aims Patients with longstanding ulcerative colitis (UC) are at increased risk of developing colorectal neoplasia. Chromoendoscopy (CE) increases detection of lesions, and Kudo pit pattern classification I and II have been suggested to be predictive of benign polyps in UC. Little is known on the use of this classification in nonmagnified high-definition (HD) (virtual) CE and narrow-band Imaging (NBI) or on the interobserver agreement. The aim of this pilot study was to assess the diagnostic accuracy and the interobserver agreement of the Kudo pit pattern classification in UC patients undergoing surveillance with methylene blue CE or NBI in a multicenter study. Methods Fifty images of lesions identified in 27 UC patients (13 neoplastic) either with classical CE (methylene blue.1%; n = 24) or NBI (n = 26) were selected by an independent investigator. Images were selected from a randomized controlled trial to compare CE and NBI. All nonmagnified images were obtained with a processor and mounted in a PowerPoint file in a standardized way (same size; black background). Ten endoscopists with extensive experience in NBI/CE were asked to assess the lesions for the predominant Kudo pit pattern (I, II, IIIL, IIIS, IV, and V) to indicate if they believed the lesion was neoplastic and how confident they were about the diagnosis. Histology was used as the criterion standard. Results Median sensitivity, specificity, negative predictive value, and positive predictive value for diagnosing neoplasia based on the presence of pit pattern other than I or II was 77%, 68%, 88%, and 46%, respectively. Diagnostic accuracy was significantly higher when a diagnosis was made with a high level of confidence (77% vs 21%, P <.001). The overall interobserver agreement for any pit pattern was only fair (κ =.282), with CE being significantly better than NBI (.322 vs.224, P <.001). From a clinical viewpoint the difference between neoplastic and non-neoplastic lesions is important. The agreement for differentiation between non-neoplastic patterns (I, II) and neoplastic patterns (IIIL, IIIS, IV, or V) was moderate (κ =.587) and even significantly better for NBI in comparison with CE (κ =.653 vs.495, P <.001). Conclusions Differentiation between non-neoplastic and neoplastic pit patterns in UC lesions shows a moderate to substantial agreement among expert endoscopists. The agreement for differentiating neoplastic from non-neoplastic lesions is significantly better for NBI in comparison with HD CE. The assessment of pit pattern I or II with nonmagnified HD CE or NBI has a high negative predictive value to rule out neoplasia. (Clinical trial registration number: NCT01882205.) © 2017 American Society for Gastrointestinal Endoscopy
http://hdl.handle.net/2268/225153
10.1016/j.gie.2017.09.024

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