Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 1248-1255 |
| Number of pages | 8 |
| Journal | Journal of Gastroenterology and Hepatology (Australia) |
| Volume | 33 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2018 Jun 1 |
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All Science Journal Classification (ASJC) codes
- Hepatology
- Gastroenterology
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A training program of a new simplified classification of magnified narrow band imaging for superficial esophageal squamous cell carcinoma. / Wang, Wen Lun; Chiu, Sherry Yueh Hsia; Lee, Ching Tai; Tseng, Cheng Hao; Chen, Chien Chuan; Han, Ming Lun; Chung, Chen Shuan; Hsieh, Ping Hsin; Chang, Wei-Lun; Wu, Ping Hsiu; Hsu, Wen Hung; Yen, Hsu Heng; Wang, Hsiu Po; Chang, Chi Yang.
In: Journal of Gastroenterology and Hepatology (Australia), Vol. 33, No. 6, 01.06.2018, p. 1248-1255.Research output: Contribution to journal › Article
TY - JOUR
T1 - A training program of a new simplified classification of magnified narrow band imaging for superficial esophageal squamous cell carcinoma
AU - Wang, Wen Lun
AU - Chiu, Sherry Yueh Hsia
AU - Lee, Ching Tai
AU - Tseng, Cheng Hao
AU - Chen, Chien Chuan
AU - Han, Ming Lun
AU - Chung, Chen Shuan
AU - Hsieh, Ping Hsin
AU - Chang, Wei-Lun
AU - Wu, Ping Hsiu
AU - Hsu, Wen Hung
AU - Yen, Hsu Heng
AU - Wang, Hsiu Po
AU - Chang, Chi Yang
PY - 2018/6/1
Y1 - 2018/6/1
N2 - 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.
AB - 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.
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U2 - 10.1111/jgh.14071
DO - 10.1111/jgh.14071
M3 - Article
C2 - 29247549
AN - SCOPUS:85047882977
VL - 33
SP - 1248
EP - 1255
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
SN - 0815-9319
IS - 6
ER -