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Validation with international comparative study for the JNET classification between Hiroshima, Japan and Porto Alegre, Brazil
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Kyoku Sumimoto1,
Shinji Tanaka1,
Kazuaki Chayama2 |
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1Department of Endoscopy, Hiroshima University Hospital, 2Department of Gastroenterology and Metabolism, Hiroshima University Hospital |
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| The Japan NBI Expert Team (JNET) classification was proposed as a first unified narrow-band imaging (NBI) magnifying endoscopic classification for colorectal tumors. It has been widely used in Japan, isn’t well known in other countries where magnifying endoscopy is not common. The Aim of this study is to evaluate the usefulness of JNET classification for colonoscopists both in Hiroshima, Japan and Porto Alegre, Brazil. Methods: Using 90 NBI magnifying still images of consecutive 90 colorectal tumors (31 adenomas, 13 Tis carcinomas, 14 superficial T1 carcinomas, and 32 deep T1 carcinomas), six colonoscopists (each three from Hiroshima and Porto Alegre; almost same professional career) conducted web trial of JNET classification diagnosis with confidence level (high/ low) and the helpful NBI findings (vessel or surface pattern). The NBI diagnostic accuracy and inter-observer agreement were analyzed. The results were compared between two countries. Results: The diagnostic accuracy of each participants were A 95%，B 83%, C 81%，D70%，E 66%，F 65%, respectively. High confidence was recorded for A 97%，B 80%, C 65%，D 72%，E 78%，F 76%. Surface pattern was more helpful in diagnosis for A 67%，B 100%, C 83%，D 47%，E 48%，F 43%. The inter-observer agreement was 0.75 for Hiroshima and 0.66 for Porto Alegre. The diagnostic accuracy with ‘high confidence’ and ‘surface pattern’ improved significantly in both groups. Conclusions: The accuracy of JNET classification diagnosis was different between countries. To generalize the JNET classification in other countries, the sufficient education system may be needed such as lectures, case discussion including better training modules. |
Index Term 1: JNET classification
Index Term 2: NBI magnifying endoscopy |
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