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A training program of a new simplified classification of magnified narrow band imaging for superficial esophageal squamous cell carcinoma
Author(s) -
Wang WenLun,
Chiu Sherry YuehHsia,
Lee ChingTai,
Tseng ChengHao,
Chen ChienChuan,
Han MingLun,
Chung ChenShuan,
Hsieh PingHsin,
Chang WeiLun,
Wu PingHsiu,
Hsu WenHung,
Yen HsuHeng,
Wang HsiuPo,
Chang ChiYang
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14071
Subject(s) - medicine , narrow band imaging , esophageal squamous cell carcinoma , magnification , endoscopy , basal cell , esophageal cancer , white light , radiology , carcinoma , nuclear medicine , cancer , artificial intelligence , optics , physics , computer science
Background and Aim Optimal staging of the invasion depth of superficial esophageal squamous cell carcinoma is vital before endoscopic treatment. A new simplified magnified narrow‐band imaging (M‐NBI) classification system based on vascular architecture has recently been developed by the Japan Esophageal Society; however, its validity remains uncertain. Methods A total of 11 experienced and 11 inexperienced endoscopists were invited to join an endoscopic training program, which was composed of pretest, educational section, and post‐test. The pretest and post‐test sections included a set of endoscopic photos from 40 subjects with superficial esophageal squamous cell carcinoma with various invasion depths. Each subject appeared twice in the test, one with white‐light imaging (WLI) only and the other with both WLI and M‐NBI. The educational section included lectures and video demonstrations. Results The accuracy of WLI alone and combined with M‐NBI at baseline were 0.53, 0.57 and 0.43, 0.41 for the experienced and inexperienced endoscopists, respectively, which then improved to 0.57, 0.63 and 0.49, 0.52 after training. Inter‐observer agreement ( k ‐value) of WLI alone and combined WLI and M‐NBI for the experienced and inexperienced endoscopists also improved from 0.61, 0.61, and 0.61, 0.53 to 0.68, 0.71, and 0.71, 0.59, respectively. Multivariate analysis revealed that the educational course but not experience in endoscopy, NBI, or magnification significantly improved the diagnostic accuracy. M‐NBI had a significant additional benefit to WLI, with an improvement in accuracy from 36% to 56% for the cases with m3/sm1 cancers ( P < 0.05). Conclusions A well‐designed training program can improve the diagnostic accuracy in evaluating cancer invasion depth, with substantial agreement.