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Proposal of a new ‘resect and discard’ strategy using magnifying narrow band imaging: P ilot study of diagnostic accuracy
Author(s) -
Takeuchi Yoji,
Hanafusa Masao,
Kanzaki Hiromitsu,
Ohta Takashi,
Hanaoka Noboru
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12248
Subject(s) - medicine , narrow band imaging , histology , histopathology , diagnostic accuracy , radiology , colonoscopy , pathology , endoscopy , colorectal cancer , cancer
Background and Aim A ‘resect and discard’ strategy using non‐magnifying narrow band imaging ( N ‐ NBI ) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI ( M ‐ NBI ) that can potentially further improve the ‘resect and discard’ strategy. We conducted a pilot study to investigate the feasibility of M ‐ NBI for the new ‘resect and discard’ strategy with consideration for advanced histology. Methods The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N ‐ NBI and M ‐ NBI , a decision (discard or send for pathology) was made based on the M ‐ NBI findings, and histological and optical diagnosis results were compared. Results Sensitivity, specificity and accuracy (95% confidence interval) of M ‐ NBI for lesions with advanced histology were 1.00 (0.36–1.00), 0.92 (0.91–0.92) and 0.92 (0.90–0.92), respectively. Whereas the management of 86% of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M ‐ NBI . The diagnostic accuracy of M ‐ NBI in distinguishing neoplastic from non‐neoplastic lesions was higher than that of N ‐ NBI . Conclusions We propose a new resect and discard strategy with advanced histology using M ‐ NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.