Comparative study of conventional colonoscopy, magnifying chromoendoscopy, and magnifying narrow-band imaging systems in the differential diagnosis of small colonic polyps between trainee and experienced endoscopist

Chun Chao Chang, Ching Ruey Hsieh, Horng Yuan Lou, Chia Lang Fang, Cheng Tiong, Jen Juh Wang, I. Van Wei, Shie Chiang Wu, Jun Nan Chen, Yuan Hung Wang

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Removal of colorectal neoplastic polyps can reduce the incidence of colorectal cancers. It is important to distinguish neoplastic from nonneoplastic polyps. We compared the ability of a trainee and an experienced endoscopist in distinguishing between neoplastic polyps and nonneoplastic polyps by conventional white-light, magnifying narrow-band imaging (NBI), and magnifying chromoendoscopy. Materials and methods: One hundred and sixty-three small colorectal polyps from 104 patients were studied. All polyps were diagnosed by trainees and experienced endoscopists using conventional white-light, magnifying NBI, and magnifying chromoendoscopy. The kappa values of interobserver agreement between trainees and experienced endoscopists were evaluated before this study. Sensitivity, specificity, and diagnostic accuracy were assessed by reference to histopathology. The first 50 polyps were diagnosed by the trainee as the first stage and the rest 113 polyps were diagnosed as the second stage. Results: Magnifying NBI and magnifying chromoendoscopy were significant better than conventional white-light by the experienced endoscopist (diagnostic accuracy: NBI 85.3%, chromoendoscopy 87.7%, conventional view 74.8%). No significant differences were found for the trainee. The kappa values (0.77∼0.85) were good for each endoscopic modality for the experienced endoscopist. However, only NBI and chromoendoscopy had acceptable kappa values (0.40∼0.48) for the trainee. The trainee improved diagnostic accuracy in the second stage, but not yielded the level of the experienced endoscopist. Conclusion: Magnifying NBI and magnifying chromoendoscopy had a better interobserver agreement than conventional white-light among trainees and experienced endoscopists. The trainee needs learning time to improve diagnostic ability, even using a new modality such as magnifying NBI.

Original languageEnglish
Pages (from-to)1413-1419
Number of pages7
JournalInternational Journal of Colorectal Disease
Volume24
Issue number12
DOIs
Publication statusPublished - 2009

Fingerprint

Narrow Band Imaging
Colonic Polyps
Colonoscopy
Polyps
Differential Diagnosis
Light
Aptitude
Colorectal Neoplasms
Learning
Sensitivity and Specificity

Keywords

  • Kappa value
  • Magnifying chromoendoscopy
  • Magnifying NBI
  • Neoplastic colorectal polyps

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Comparative study of conventional colonoscopy, magnifying chromoendoscopy, and magnifying narrow-band imaging systems in the differential diagnosis of small colonic polyps between trainee and experienced endoscopist. / Chang, Chun Chao; Hsieh, Ching Ruey; Lou, Horng Yuan; Fang, Chia Lang; Tiong, Cheng; Wang, Jen Juh; Wei, I. Van; Wu, Shie Chiang; Chen, Jun Nan; Wang, Yuan Hung.

In: International Journal of Colorectal Disease, Vol. 24, No. 12, 2009, p. 1413-1419.

Research output: Contribution to journalArticle

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abstract = "Background: Removal of colorectal neoplastic polyps can reduce the incidence of colorectal cancers. It is important to distinguish neoplastic from nonneoplastic polyps. We compared the ability of a trainee and an experienced endoscopist in distinguishing between neoplastic polyps and nonneoplastic polyps by conventional white-light, magnifying narrow-band imaging (NBI), and magnifying chromoendoscopy. Materials and methods: One hundred and sixty-three small colorectal polyps from 104 patients were studied. All polyps were diagnosed by trainees and experienced endoscopists using conventional white-light, magnifying NBI, and magnifying chromoendoscopy. The kappa values of interobserver agreement between trainees and experienced endoscopists were evaluated before this study. Sensitivity, specificity, and diagnostic accuracy were assessed by reference to histopathology. The first 50 polyps were diagnosed by the trainee as the first stage and the rest 113 polyps were diagnosed as the second stage. Results: Magnifying NBI and magnifying chromoendoscopy were significant better than conventional white-light by the experienced endoscopist (diagnostic accuracy: NBI 85.3{\%}, chromoendoscopy 87.7{\%}, conventional view 74.8{\%}). No significant differences were found for the trainee. The kappa values (0.77∼0.85) were good for each endoscopic modality for the experienced endoscopist. However, only NBI and chromoendoscopy had acceptable kappa values (0.40∼0.48) for the trainee. The trainee improved diagnostic accuracy in the second stage, but not yielded the level of the experienced endoscopist. Conclusion: Magnifying NBI and magnifying chromoendoscopy had a better interobserver agreement than conventional white-light among trainees and experienced endoscopists. The trainee needs learning time to improve diagnostic ability, even using a new modality such as magnifying NBI.",
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AU - Hsieh, Ching Ruey

AU - Lou, Horng Yuan

AU - Fang, Chia Lang

AU - Tiong, Cheng

AU - Wang, Jen Juh

AU - Wei, I. Van

AU - Wu, Shie Chiang

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AU - Wang, Yuan Hung

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