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Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics

Gut, 2013-12, Vol.62 (12), p.1704-1713 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Copyright: 2013 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2013 ;ISSN: 0017-5749 ;EISSN: 1468-3288 ;DOI: 10.1136/gutjnl-2012-303965 ;PMID: 23300139 ;CODEN: GUTTAK

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  • Title:
    Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: a meta-analysis of diagnostic operating characteristics
  • Author: McGill, Sarah K ; Evangelou, Evangelos ; Ioannidis, John P A ; Soetikno, Roy M ; Kaltenbach, Tonya
  • Subjects: Accuracy ; Biomedical research ; Classification ; Colonic Polyps ; Colonic Polyps - diagnosis ; Colonoscopy ; Colonoscopy - methods ; Colorectal cancer ; Colorectal Cancer Screening ; Colorectal Neoplasia ; Colorectal Neoplasms - diagnosis ; Cost control ; Diagnosis, Differential ; Endoscopy ; Histology ; Humans ; Medical screening ; Meta-Analysis ; Narrow Band Imaging - methods ; Pathology ; Patients ; ROC Curve ; Sensitivity and Specificity ; Studies ; Surveillance ; Tumors
  • Is Part Of: Gut, 2013-12, Vol.62 (12), p.1704-1713
  • Description: Purpose Many studies have reported on the use of narrow band imaging (NBI) colonoscopy to differentiate neoplastic from non-neoplastic colorectal polyps. It has potential to replace pathological diagnosis of diminutive polyps. We aimed to perform a systematic review and meta-analysis on the real-time diagnostic operating characteristics of NBI colonoscopy. Methods We searched PubMed, SCOPUS and Cochrane databases and abstracts. We used a two-level bivariate meta-analysis following a random effects model to summarise the data and fit hierarchical summary receiver-operating characteristic (HSROC) curves. The area under the HSROC curve serves as an indicator of the diagnostic test strength. We calculated summary sensitivity, specificity and negative predictive value (NPV). We assessed agreement of surveillance interval recommendations based on endoscopic diagnosis compared to pathology. Results For NBI diagnosis of colorectal polyps, the area under the HSROC curve was 0.92 (95% CI 0.90 to 0.94), based on 28 studies involving 6280 polyps in 4053 patients. The overall sensitivity was 91.0% (95% CI 87.6% to 93.5%) and specificity was 82.6% (95% CI 79.0% to 85.7%). In eight studies (n=2146 polyps) that used high-confidence diagnostic predictions, sensitivity was 93.8% and specificity was 83.3%. The NPVs exceeded 90% when 60% or less of all polyps were neoplastic. Surveillance intervals based on endoscopic diagnosis agreed with those based on pathology in 92.6% of patients (95% CI 87.9% to 96.3%). Conclusions NBI diagnosis of colorectal polyps is highly accurate—the area under the HSROC curve exceeds 0.90. High-confidence predictions provide >90% sensitivity and NPV. It shows high potential for real-time endoscopic diagnosis.
  • Publisher: England: BMJ Publishing Group Ltd and British Society of Gastroenterology
  • Language: English
  • Identifier: ISSN: 0017-5749
    EISSN: 1468-3288
    DOI: 10.1136/gutjnl-2012-303965
    PMID: 23300139
    CODEN: GUTTAK
  • Source: BMJ Open Access Journals
    MEDLINE
    Alma/SFX Local Collection
    ProQuest Central
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