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Zooming in on Barrett oesophagus using narrow-band imaging: an international observer agreement study.

Abstract：

BACKGROUND:Several classifications of mucosal morphology have been proposed in Barrett oesophagus using narrow-band imaging (NBI). We evaluated a simplified classification in which only the regularity of mucosal and vascular patterns were evaluated. AIM:To assess the inter and intraobserver agreement and the correlation with histology of a simplified NBI classification of mucosal morphology in Barrett oesophagus combining the experience of two referral centres. METHODS:Two hundred NBI images [57 high-grade intraepithelial neoplasia (HGIN)/early cancer (EC)] were evaluated twice by four NBI-experienced and four nonexperienced endoscopists in the field of NBI. Endoscopists assessed each image for: quality, suspicion for dysplasia, and regularity of mucosal and vascular patterns. Observer agreement was assessed using kappa statistics. RESULTS:Overall interobserver agreement for the items evaluated was 'moderate' and varied between 0.42 and 0.44. Overall intraobserver agreement was 'moderate' to 'substantial' (kappa 0.60-0.62). There were no significant differences in agreement between expert and nonexpert endoscopists. Endoscopist correctly identified 71% of the images containing HGIN/EC. Of the areas without HGIN/EC, 68% were correctly identified as not suspicious. Again, there were no significant differences between experts and nonexperts. CONCLUSION:Our proposed, simplified classification for Barrett mucosal morphology has a moderate interobserver and a moderate to substantial intraobserver agreement. The lack of differences in agreements between expert and nonexpert endoscopists suggests a short learning curve. The disappointing rate for correctly indentifying HGIN/EC, questions, however, whether detailed inspection of Barrett oesophagus with NBI can replace histological sampling.

journal_name

Eur J Gastroenterol Hepatol

journal_title

European journal of gastroenterology & hepatology

authors

Alvarez Herrero L,Curvers WL,Bansal A,Wani S,Kara M,Schenk E,Schoon EJ,Lynch CR,Rastogi A,Pondugula K,Weusten B,Sharma P,Bergman JJ

doi

10.1097/MEG.0b013e3283271e87

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

1068-75

issue

eissn

0954-691X

issn

1473-5687

journal_volume

pub_type

杂志文章,多中心研究

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Zooming in on Barrett oesophagus using narrow-band imaging: an international observer agreement study.