Abstract
Aims The main aim was to determine and compare the diagnostic accuracy of the narrow-band imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team (JNET) classification in predicting histology. Secondary aim was to determine the positive predictive value (PPV) for the NICE and JNET classification. Methods 211 patients aged 18–75 years (130 men, 62%; mean age 60 years) underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (defined by size lesions ≥ 10 mm). The Paris classification, NICE and JNET classifications were used for each lesion. The results were compared with the final pathological diagnoses. Results 257 lesions were analyzed, including 8 (3.1 %) hyperplastic polyps, 47 sessile serrated polyps (18.2 %), 152 (59.1 %) adenomas with LGD, 36 (14.2 %) high-grade adenomas, 12 (4,6 %) superficial submucosal (SM-s) carcinomas and 2 (0.8 %) deep submucosal (SM-d) carcinomas. A total of 200 lesions (77.8 %) were correctly classified according to the JNET classification and 242 lesions (94.2 %) were correctly classified according to the NICE classification. The PPV for NICE 1 lesion was 95.9 %, NICE 2 97.0 % and NICE 3 22.0 %. The PPV for JNET 1 lesions was 95.9 %, JNET 2A 83 %, JNET 2B 52.2 % and JNET 3 22.5 %. Conclusions The NICE classification was associated with a higher proportion of correctly classified lesions compared to the JNET classification. NICE 3 and JNET 3 were characterized by low PPV. NBI virtual chromoendoscopy shows a low PPV for HGD adenomas and SM-s carcinomas. Increasing the accuracy of the prediction of these lesions and determining the limiting factors will be the subject of further investigation. Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany