AI Article Synopsis

  • - The study investigates the effectiveness of Narrow Band Imaging (NBI) for identifying lesions in ulcerative colitis (UC) using three different classification systems: NICE, Kudo, and the modified Kudo-IBD.
  • - Results showed disparities in diagnostic performance, with Kudo-IBD achieving the highest sensitivity (86%) and specificity (79%), indicating its superiority for UC lesion characterization compared to NICE and Kudo classifications.
  • - The findings suggest that while NBI's overall diagnostic accuracy for distinguishing between neoplastic and non-neoplastic lesions in UC is generally low, the modified Kudo classification significantly improves this accuracy.

Article Abstract

Purpose: The diagnostic accuracy of Narrow Band Imaging (NBI) in the endoscopic surveillance of ulcerative colitis (UC) has been disappointing in most trials which used the Kudo classification. We aim to compare the performance of NBI in the lesion characterization of UC, when applied according to three different classifications (NICE, Kudo, Kudo-IBD).

Methods: In a prospective, real-life study, all visible lesions found during consecutive surveillance colonoscopies with NBI (Exera-II CV-180) for UC were classified as suspected or non-suspected for neoplasia according to the NICE, Kudo and Kudo-IBD criteria. The sensitivity (SE), specificity (SP), positive (+LR) and negative (-LR) likelihood ratios of the three classifications were calculated, using histology as the reference standard.

Results: 394 lesions (mean size 6 mm, range 2-40 mm) from 84 patients were analysed. Twenty-one neoplastic (5%), 49 hyperplastic (12%), and 324 inflammatory (82%) lesions were found. The diagnostic accuracy of the NICE, Kudo and Kudo-IBD classifications were, respectively: SE 76%-71%-86%; SP 55-69%-79% (p < 0.05 Kudo-IBD vs. both Kudo and NICE); +LR 1.69-2.34-4.15 (p < 0.05 Kudo-IBD vs. both Kudo and NICE); -LR 0.43-0.41-0.18.

Conclusion: The diagnostic accuracy of NBI in the differentiation of neoplastic and non-neoplastic lesions in UC is low if used with conventional classifications of the general population, but it is significantly better with the modified Kudo classification specific for UC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116216PMC
http://dx.doi.org/10.1007/s00384-024-04635-6DOI Listing

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