Objective validity of the Japan Narrow-Band Imaging Expert Team classification system for the differential diagnosis of colorectal polyps

Yosuke Minoda, Haruei Ogino, Takatoshi Chinen, Eikichi Ihara, Kazuhiro Haraguchi, Hirotada Akiho, Nobuyoshi Takizawa, Akira Aso, Yosuke Tomita, Mitsuru Esaki, Keishi Komori, Yoshihiro Otsuka, Tsutomu Iwasa, Yoshihiro Ogawa

Research output: Contribution to journalArticle

Abstract

Background and Aim: The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants. Methods: Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared. Results: Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training. Conclusion: The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.

Original languageEnglish
JournalDigestive Endoscopy
DOIs
Publication statusPublished - Jan 1 2019

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Narrow Band Imaging
Polyps
Japan
Differential Diagnosis
Colonoscopy
Endoscopy
Colorectal Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Objective validity of the Japan Narrow-Band Imaging Expert Team classification system for the differential diagnosis of colorectal polyps. / Minoda, Yosuke; Ogino, Haruei; Chinen, Takatoshi; Ihara, Eikichi; Haraguchi, Kazuhiro; Akiho, Hirotada; Takizawa, Nobuyoshi; Aso, Akira; Tomita, Yosuke; Esaki, Mitsuru; Komori, Keishi; Otsuka, Yoshihiro; Iwasa, Tsutomu; Ogawa, Yoshihiro.

In: Digestive Endoscopy, 01.01.2019.

Research output: Contribution to journalArticle

Minoda, Yosuke ; Ogino, Haruei ; Chinen, Takatoshi ; Ihara, Eikichi ; Haraguchi, Kazuhiro ; Akiho, Hirotada ; Takizawa, Nobuyoshi ; Aso, Akira ; Tomita, Yosuke ; Esaki, Mitsuru ; Komori, Keishi ; Otsuka, Yoshihiro ; Iwasa, Tsutomu ; Ogawa, Yoshihiro. / Objective validity of the Japan Narrow-Band Imaging Expert Team classification system for the differential diagnosis of colorectal polyps. In: Digestive Endoscopy. 2019.
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abstract = "Background and Aim: The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants. Methods: Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared. Results: Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90{\%} accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training. Conclusion: The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.",
author = "Yosuke Minoda and Haruei Ogino and Takatoshi Chinen and Eikichi Ihara and Kazuhiro Haraguchi and Hirotada Akiho and Nobuyoshi Takizawa and Akira Aso and Yosuke Tomita and Mitsuru Esaki and Keishi Komori and Yoshihiro Otsuka and Tsutomu Iwasa and Yoshihiro Ogawa",
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AU - Minoda, Yosuke

AU - Ogino, Haruei

AU - Chinen, Takatoshi

AU - Ihara, Eikichi

AU - Haraguchi, Kazuhiro

AU - Akiho, Hirotada

AU - Takizawa, Nobuyoshi

AU - Aso, Akira

AU - Tomita, Yosuke

AU - Esaki, Mitsuru

AU - Komori, Keishi

AU - Otsuka, Yoshihiro

AU - Iwasa, Tsutomu

AU - Ogawa, Yoshihiro

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AB - Background and Aim: The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants. Methods: Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared. Results: Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training. Conclusion: The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis.

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