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Diagnostic efficacy of the Japan NBI Expert Team classification with dual-focus magnification for colorectal tumors

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Abstract

Background and aims

The Japan NBI Expert Team (JNET) classification is the first unified classification criteria for colorectal tumors using magnifying narrow-band imaging (NBI) in Japan. However, the diagnostic stratification ability of the JNET classification with dual-focus magnifying NBI (DF-JNET) has remained obscure. The aim of this study was to validate the diagnostic stratification ability of DF-JNET for colorectal tumors in two Japanese referral centers.

Methods

A multicenter retrospective image evaluation study was conducted by three experienced endoscopists, including an original JNET member who was also involved in establishing the diagnostic criteria. A total of two images, namely, one representative non-magnified white light image and one representative DF-NBI image for each of the 557 consecutive lesions were used in the evaluation study. The diagnostic value of DF-JNET was calculated based on the evaluation data.

Results

The sensitivity, specificity, positive and negative predictive values, and accuracy of DF-JNET Type 1 for differentiating between non-neoplastic and neoplastic lesions were 78.1%, 98.6%, 89.1%, 96.8%, and 95.9%, respectively; of Type 2A lesions for differentiating low-grade dysplasia from others were 98.0%, 76.5%, 94.9%, 89.7%, and 94.1%, respectively; of Type 2B lesions for differentiating high-grade dysplasia and shallow submucosal invasive carcinoma from others were 43.5%, 99.1%, 66.7%, 97.6%, and 96.8%, respectively; and of Type 3 lesions for differentiating deep submucosal invasive carcinoma from others were 83.3%, 99.5%, 62.5%, 99.8%, and 99.3%, respectively.

Conclusions

All DF-JNET types had an over 90% diagnostic accuracy for the histological prediction of colorectal tumors. DF-JNET might contribute to appropriate treatment choices, such as endoscopic resection or surgery, not only in Japan but also in Western countries in which the use of optical zoom endoscopy is limited.

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Acknowledgements

We are indebted to Helena Popiel, assistant professor of the Department of International Medical Communications of Tokyo Medical University for her editorial review of this manuscript.

Funding

All authors have no financial relationships with a commercial entity producing health-care-related products and services relevant to this article.

Disclosures

Yohei Koyama, Masakatsu Fukuzawa, Shin Kono, Akira Madarame, Takashi Morise, Kumiko Uchida, Hayato Yamaguchi, Akihiko Sugimoto, Naoyoshi Nagata, Takashi Kawai, Hiroyuki Takamaru, Masau Sekiguchi, Masayoshi Yamada, Taku Sakamoto, Takahisa Matsuda, Yutaka Saito, and Takao Itoi have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Yohei Koyama, Masakatsu Fukuzawa, Shin Kono, Akira Madarame, Takashi Morise, Kumiko Uchida, Hayato Yamaguchi, Akihiko Sugimoto & Takao Itoi

  2. Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan

    Naoyoshi Nagata & Takashi Kawai

  3. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

    Hiroyuki Takamaru, Masau Sekiguchi, Masayoshi Yamada, Taku Sakamoto, Takahisa Matsuda & Yutaka Saito

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  1. Yohei Koyama
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Correspondence to Takao Itoi.

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Koyama, Y., Fukuzawa, M., Kono, S. et al. Diagnostic efficacy of the Japan NBI Expert Team classification with dual-focus magnification for colorectal tumors. Surg Endosc 36, 5032–5040 (2022). https://doi.org/10.1007/s00464-021-08863-7

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