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Image assessment of Barrett’s esophagus using the simplified narrow band imaging classification

  • Original Article—Alimentary Tract
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Abstract

Background

A simplified narrow band imaging (NBI) classification has been proposed with the objective of integrating multiple classifications of NBI surface patterns in Barrett’s esophagus (BE). Little is known about the impact of the simplified NBI classification on the diagnosis of BE when using high-definition magnification endoscopy with NBI (HM-NBI). This study aimed to evaluate (a) the reproducibility of NBI surface patterns and predicted histology and (b) the diagnostic accuracy of interpreting HM-NBI images by using the simplified NBI classification.

Methods

Two hundred and forty-eight HM-NBI images from macroscopically normal areas in patients with BE were retrieved from endoscopy databases and randomized for review by four endoscopists (two experts, two non-experts). We evaluated inter- and intra-observer agreement of the interpretation of NBI surface patterns and the predicted histology (dysplasia vs. non-dysplasia), as calculated by using κ statistics, and diagnostic values of the prediction.

Results

The overall inter-observer agreements were substantial for mucosal pattern (κ = 0.73) and vascular pattern (κ = 0.71), and almost perfect for predicting dysplastic histology (κ = 0.80). The overall intra-observer agreements were almost perfect for mucosal (κ = 0.84) and vascular patterns (κ = 0.86), and predicting dysplastic histology (κ = 0.89). The mean accuracy in predicting dysplastic histology for all reviewers was 95 % (experts: 96.8 %, non-experts: 93.1 %).

Conclusions

The simplified NBI classification has the potential to provide high diagnostic reproducibility and accuracy when using HM-NBI.

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Acknowledgments

We are grateful to Professor Hisao Tajiri for his contribution as a proposer of this study. We would like to thank Dr. Shinichi Hirooka and Dr. Masako Nishikawa for advice on histopathology and statistical analysis, respectively.

Author information

Authors and Affiliations

  1. Department of Endoscopy, The Jikei University Katsushika Medical Center, Tokyo, Japan

    Masayuki Kato

  2. Department of Endoscopy, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Kenichi Goda & Akira Dobashi

  3. Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yuichi Shimizu & Masakazu Takahashi

  4. Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan

    Masahiro Ikegami

  5. Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan

    Tadakazu Shimoda

  6. National Hospital Organization Hakodate Hospital, Hakodate, Japan

    Mototsugu Kato

  7. Division of Gastroenterology, Hepatology and Motility, University of Kansas Medical Center, Kansas, USA

    Prateek Sharma

Authors
  1. Masayuki Kato
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  2. Kenichi Goda
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  3. Yuichi Shimizu
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  4. Akira Dobashi
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  5. Masakazu Takahashi
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  6. Masahiro Ikegami
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  7. Tadakazu Shimoda
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  8. Mototsugu Kato
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  9. Prateek Sharma
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Corresponding author

Correspondence to Kenichi Goda.

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The authors declare that they have no conflicts of interest.

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Kato, M., Goda, K., Shimizu, Y. et al. Image assessment of Barrett’s esophagus using the simplified narrow band imaging classification. J Gastroenterol 52, 466–475 (2017). https://doi.org/10.1007/s00535-016-1239-4

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  • DOI: https://doi.org/10.1007/s00535-016-1239-4

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