Diagnostic ability of Japan Narrow-Band Imaging Expert Team classification for colorectal lesions by magnifying endoscopy with blue laser imaging versus narrow-band imaging

Background and study aims The Japan Narrow-band imaging (NBI) Expert Team (JNET) classification was proposed for evaluating colorectal lesions. However, it remains unknown whether the JNET classification can be applied to magnifying endoscopy with image-enhanced endoscopies other than NBI. This study aimed to compare the diagnostic ability of JNET classification by magnifying endoscopy with blue laser imaging (ME-BLI) and with ME-NBI. Patients and methods We retrospectively assessed consecutive patients diagnosed per the JNET classification by ME-BLI (BLI group) or ME-NBI (NBI group) between March 2014 and June 2017. We compared the diagnostic value of JNET classification between the groups with one-to-one propensity score matching. Results Four hundred and seventy-one propensity score-matched pairs of lesions were analyzed. In the BLI and NBI groups, the overall diagnostic accuracies were 92.1 % and 91.7 %, respectively, and those for differentiating between neoplastic and non-neoplastic polyps were 96.6 % and 96.8 %, respectively. The positive predictive value by each JNET classification in BLI vs. NBI group was 90.6 % vs. 96.2 % in Type 1, 94.3 % vs. 94.6 % in Type 2A, 57.7 % vs. 42.3 % in Type 2B, and 100 % vs. 91.7 % in Type 3. The negative predictive value was 97.0 % vs. 96.9 % in Type 1, 88.1 % vs. 82.8 % in Type 2A, 98.0 % vs. 98.2 % in Type 2B, and 98.5 % vs. 98.7 % in Type 3. No statistical difference in the diagnostic results was found between the groups. Conclusions The diagnostic ability of the JNET classification by ME-BLI and ME-NBI was comparable, with the former also applicable for diagnosis of colorectal lesions.

The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma

Background. The present study aimed to evaluate the efficacy of linked color imaging (LCI) in diagnosing Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC). Methods. A total of 112 and 12 consecutive patients with BE and EAC were analyzed. The visibility scores of BE and EAC ranging from 4 (excellent visibility) to 0 (not detectable) were evaluated by three trainees and three experts using white light imaging (WLI), LCI mode, and blue laser imaging bright (BLI-b) mode. In addition, L ∗ a ∗ b ∗ color values and color differences ( Δ E ∗ ) were evaluated using the CIELAB color space system. Results. The visibility score of the BE in LCI mode ( 2.94 ± 1.32 ) was significantly higher than those in WLI ( 2.46 ± 1.48 ) and BLI-b mode ( 2.35 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent gastric mucosa in LCI mode ( 17.11 ± 8.53 ) was significantly higher than those in other modes ( 12.52 ± 9.37 in WLI and 11.96 ± 6.59 in BLI-b mode, p < 0.01 ). The visibility scores of EAC in LCI mode ( 2.56 ± 1.47 ) and BLI-b mode ( 2.51 ± 1.28 ) were significantly higher than that in WLI ( 1.64 ± 1.46 ) ( p < 0.01 ). The color difference ( Δ E ∗ ) from the adjacent normal Barrett’s mucosa in LCI mode ( 19.96 ± 7.97 ) was significantly higher than that in WLI ( 12.95 ± 11.86 ) ( p = 0.03 ). Conclusion. The present findings suggest that LCI increases the visibility of BE and EAC and contributes to the improvement of the detection of these lesions.