Journal ArticleDOI
Diagnostic performance of narrowed spectrum endoscopy, autofluorescence imaging, and confocal laser endomicroscopy for optical diagnosis of colonic polyps: a meta-analysis
Linda K. Wanders,Linda K. Wanders,James E. East,S. E. Uitentuis,Mariska M.G. Leeflang,Evelien Dekker +5 more
TLDR
All endoscopic imaging techniques other than autofluorescence imaging could be used by appropriately trained endoscopists to make a reliable optical diagnosis for colonic lesions in daily practice.Abstract:
Summary Background Novel endoscopic technologies could allow optical diagnosis and resection of colonic polyps without histopathological testing. Our aim was to establish the sensitivity, specificity, and real-time negative predictive value of three types of narrowed spectrum endoscopy (narrow-band imaging [NBI], image-enhanced endoscopy [i-scan], and Fujinon intelligent chromoendoscopy [FICE]), confocal laser endomicroscopy (CLE), and autofluorescence imaging for differentiation between neoplastic and non-neoplastic colonic lesions. Methods We identified relevant studies through a search of Medline, Embase, PubMed, and the Cochrane Library. Clinical trials and observational studies were eligible for inclusion when the diagnostic performance of NBI, i-scan, FICE, autofluorescence imaging, or CLE had been assessed for differentiation, with histopathology as the reference standard, and for which a 2 × 2 contingency table of lesion diagnosis could be constructed. We did a random-effects bivariate meta-analysis using a non-linear mixed model approach to calculate summary estimates of sensitivity and specificity, and plotted estimates in a summary receiver-operating characteristic curve. Findings We included 91 studies in our analysis: 56 were of NBI, ten of i-scan, 14 of FICE, 11 of CLE, and 11 of autofluorescence imaging (more than one of the investigated modalities assessed in eight studies). For NBI, overall sensitivity was 91·0% (95% CI 88·6–93·0), specificity 85·6% (81·3–89·0), and real-time negative predictive value 82·5% (75·4–87·9). For i-scan, overall sensitivity was 89·3% (83·3–93·3), specificity 88·2% (80·3–93·2), and real-time negative predictive value 86·5% (78·0–92·1). For FICE, overall sensitivity was 91·8% (87·1–94·9), specificity 83·5% (77·2–88·3), and real-time negative predictive value 83·7% (77·5–88·4). For autofluorescence imaging, overall sensitivity was 86·7% (79·5–91·6), specificity 65·9% (50·9–78·2), and real-time negative predictive value 81·5% (54·0–94·3). For CLE, overall sensitivity was 93·3% (88·4–96·2), specificity 89·9% (81·8–94·6), and real-time negative predictive value 94·8% (86·6–98·1). Interpretation All endoscopic imaging techniques other than autofluorescence imaging could be used by appropriately trained endoscopists to make a reliable optical diagnosis for colonic lesions in daily practice. Further research should be focused on whether training could help to improve negative predictive values. Funding None.read more
Citations
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Journal ArticleDOI
Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.
Michal F. Kaminski,Cesare Hassan,Raf Bisschops,Juergen Pohl,Maria Pellise,Evelien Dekker,Ana Ignjatovic-Wilson,Arthur Hoffman,Gaius Longcroft-Wheaton,Denis Heresbach,Jean-Marc Dumonceau,James E. East +11 more
TL;DR: Advanced imaging techniques will need to be applied in specific patient groups in routine clinical practice and to be taught in endoscopic training programs.
Journal ArticleDOI
ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps.
Barham K. Abu Dayyeh,Nirav Thosani,Vani J. Konda,Michael B. Wallace,Douglas K. Rex,Shailendra S. Chauhan,Joo Ha Hwang,Sri Komanduri,Michael A. Manfredi,John T. Maple,Faris Murad,Uzma D. Siddiqui,Subhas Banerjee +12 more
TL;DR: The thresholds established by the ASGE PIVI for real-time endoscopic assessment of the histology of diminutive polyps have been met, at least with NBI optical biopsy, with endoscopists who are expert in using this advanced imaging technology and when assessments are made with high confidence.
Journal ArticleDOI
At risk or not at risk? A meta-analysis of the prognostic accuracy of psychometric interviews for psychosis prediction.
Paolo Fusar-Poli,Paolo Fusar-Poli,Marco Cappucciati,Grazia Rutigliano,Frauke Schultze-Lutter,Ilaria Bonoldi,Stefan Borgwardt,Anita Riecher-Rössler,Jean Addington,Diana O. Perkins,Scott W. Woods,Thomas H. McGlashan,Jimmy Lee,Joachim Klosterkötter,Alison R. Yung,Philip McGuire,Philip McGuire +16 more
TL;DR: Findings support the use of psychometric prognostic interviews for CHR as clinical tools for an indicated prevention in subjects seeking help at high risk services worldwide.
Journal ArticleDOI
Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: the Detect Inspect Characterise Resect and Discard 2 (DISCARD 2) study
Colin J Rees,P T Rajasekhar,Ana Wilson,Helen Close,Matthew D. Rutter,Matthew D. Rutter,Brian P. Saunders,James E. East,Rebecca Maier,Morgan Moorghen,Usman Muhammad,Helen C. Hancock,Anthoor Jayaprakash,Chris MacDonald,Arvind Ramadas,Anjan Dhar,James Mason +16 more
TL;DR: This large multicentre study demonstrates that NBI optical diagnosis cannot currently be recommended for application in routine clinical practice and neither colonoscopist expertise, confidence in diagnosis nor use of high definition colonoscopy independently improved test accuracy.
Journal ArticleDOI
Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review.
James E. East,Jasper L.A. Vleugels,Philip Roelandt,Pradeep Bhandari,Raf Bisschops,Evelien Dekker,Cesare Hassan,Gareth Horgan,Ralf Kiesslich,Gaius Longcroft-Wheaton,Ana Wilson,Jean-Marc Dumonceau +11 more
TL;DR: In this article, a technical review of the use of advanced endoscopic imaging in GI endoscopy is presented, which is based on a systematic literature search to evaluate the evidence supporting the adoption of such technologies throughout the GI tract.
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