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• W2020517718 abstract "Background: NBI has been described as “electronic dye-spray”. Using optical filters it enhances the contrast for superficial blood vessels which enhances the mucosal pattern (pit pattern); with magnification this allows an estimate of the likely histology of a polyp in vivo. Method: Using a third generation prototype NBI system which can magnify x 100 (XCF-H240FZL/I video colonoscope, XCLV-260HP xenon light source and XCV-260HP video system centre, Olympus Medical System Corp., Tokyo, Japan) we took 21 NBI magnification endoscopic photographs of colonic polyps. Two experts (NS and BPS) were asked to assess the pit pattern according to the Kudo classification and judge the polyps to be neoplastic or non-neoplastic. One assessor also graded the intensity (darkness) of the vascular pattern, as either lower, the same, or higher than that of the background mucosa. These were compared with histological findings. Results: Polyps size ranged from 1-10 mm. Adenomatous, hyperplastic and inflammatory polyps were assessed (Table 1, assessor 1/ assessor 2). Pit pattern mean sensitivity and specificity for neoplasia was 62% and 50%; however specificity improved to 75% if inflammatory polyps were excluded. Positive (PPV) and negative predictive values (NPV) were 66% and 44%. Some inflammatory polyps were considered non-neoplastic despite type III/IV pit pattern. Vascular pattern intensity alone gave a sensitivity of 77% and specificity 75%, PPV 83%, NPV 66% (Table 2). A combination of vascular pattern intensity and Kudo pit pattern gave a sensitivity of 85% and specificity of 100%, PPV 100%, NPV 66% if inflammatory polyps were excluded. Conclusion: Early experience using NBI with magnification and Kudo pit pattern alone suggests that it is inferior to results with chromoendoscopy. Inflammatory polyps were especially difficulty to classify correctly. Vascular pattern intensity was a more powerful predictor of neoplasia than pit pattern and may be a simple predictor for neoplasia in non-inflammatory polyps, with pit pattern a back up in equivocal cases. Table 1Kudo Pit Pattern with NBI and Magnification Kudo Classification Polyp Type I II IIIS/L IV V Assesed as Neoplastic Adenoma (n = 13) 0/2 4/4 8/5 0/2 0/0 9/7 Hyperplastic (n = 4) 0/1 2/3 1/0 1/0 0/0 2/0 Inflammatory (n = 4) 0/0 0/0 1/2 3/2 0/0 4/2 Open table in a new tab Table 2Vascular Pattern Intensity with NBI and Magnification Vascular Pattern Intensity Polyp Type Low Same High Assessed as Neoplastic Adenoma (n = 13) 1 2 10 10 Hyperplastic (n = 4) 1 3 0 0 Inflammatory (n = 4) 0 2 2 2 Open table in a new tab" @default.
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• W2020517718 title "Vascular Pattern Intensity: A New Classification System to Differentiate Neoplastic and Non-Neoplastic Lesions in the Colon Using Narrow Band Imaging (NBI) with Magnification" @default.
• W2020517718 doi "https://doi.org/10.1016/j.gie.2006.03.614" @default.
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