COMPARATIVE EVALUATION OF ENDOSCOPIC FACTORS FROM CONVENTIONAL COLONOSCOPY AND NARROW-BAND IMAGING OF COLORECTAL LESIONS

Background: Narrow-band imaging (NBI) diagnosis of colorectal lesions requires further consideration and standardized classification for attaining consensus among endoscopists. Objective: Compare vascular findings and diagnosis of colorectal lesions using various endoscopic images to assess effectiveness of NBI with magnification. Method: Three endoscopic factors (vascular findings; diagnosis from NBI with magnification images; and total diagnosis from all available colonoscopic images including white light endoscopy, chromoendoscopy, NBI with magnification and magnifying chromoendoscopy) for 15 colorectal lesions were evaluated by 12 expert colonoscopists (Group A), 36 endoscopists not expert in colonoscopy (Group B) and 55 individuals not medical doctors, but familiar with gastrointestinal endoscopy or other medical products (Group C). We calculated accuracy percentages for all three endoscopic factors based on responses from each group. Highest percentage for vascular finding, NBI with magnification diagnosis and total diagnosis for each lesion assumed to be opinion of each group. We compared incidence of agreement among three groups and calculated invasion depth diagnostic accuracy rate for each group. Results: For vascular findings from NBI with magnification images, incidence of complete agreement among three groups was 46.7%, incidence of disagreement among three groups was 46.7% and incidence of complete disagreement among three groups was 6.7%. For diagnosis from NBI with magnification images and total diagnosis from all available endoscopic images, incidence of complete agreement, disagreement and complete disagreement were 40.0%, 60.0% and 0.0%, respectively, and 60.0%, 40.0% and 0.0%, respectively. Invasion depth diagnostic accuracy from NBI with magnification images and all available endoscopic images were 60.0% and 73.3%, respectively, in Group A; 46.7% and 66.7%, respectively, in Group B; and 46.6% and 60.0%, respectively, in Group C. Conclusion: Results suggest some level of educational training is required for effective application of NBI with magnification for precise diagnosis of colorectal lesions.