Endoscopy 2020; 52(S 01): S51
DOI: 10.1055/s-0040-1704156
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 14:30 – 16:00 Polyp forensics: Colon advanced Wicklow Meeting Room 3 Imaging 2
© Georg Thieme Verlag KG Stuttgart · New York

VALIDATION OF THE BASIC CLASSIFICATION SYSTEM FOR THE OPTICAL DIFFERENTATION BETWEEN NEOPLASTIC AND NON-NEOPLASTIC SUBCENTRIMETRIC POLYP HISTOLOGY BY ENDOSCOPIC EXPERTS AND TRAINEE ENDOSCOPISTS

BD Lovász
1   Semmelweis University, 1st Department of Medicine, Budapest, Hungary
2   Semmelweis University, Institute of Applied Health Sciences, Budapest, Hungary
,
Á Finta
3   Endo-Kapszula Health Centre and Endoscopy Unit, Székesfehérvár, Hungary
,
M Szalai
3   Endo-Kapszula Health Centre and Endoscopy Unit, Székesfehérvár, Hungary
,
K Zsobrák
3   Endo-Kapszula Health Centre and Endoscopy Unit, Székesfehérvár, Hungary
,
L Oczella
3   Endo-Kapszula Health Centre and Endoscopy Unit, Székesfehérvár, Hungary
,
I Hritz
4   Semmelweis University, 1st Department of Surgery, , Budapest, Hungary
,
Z Dubravcsik
5   Bács-Kiskun County Hospital, Department of Gastroenterology and OMCH Endoscopy Unit, Kecskemét, Hungary
,
L Madácsy
3   Endo-Kapszula Health Centre and Endoscopy Unit, Székesfehérvár, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims

    Background Blue Light Imaging (BLI) is a new electronic chromoendoscopic technology that enhances mucosal pits and capillary patterns. A new BLI classification was recently developed to facilitate better endoscopic characterization of colorectal polyps (BLI Adenoma Serrated International Classification (BASIC)). The aim of our present study was to analyze and validate the BASIC classification in predicting polyp histology of experienced and trainee endoscopists.

    Methods Five colonoscopic experts (more than 2000 colonoscopy per year and 20000 during their carrier) familiar with BASIC classification and five trainee endoscopist (1-2 year of colonoscopy experience and 500-1000 colonoscopy during their carrier) participated in this study. 61 HQ, HD polyp pictures made with BLI combined with 50 times optical zoom were randomly selected from our anonymous electronic database (31 neoplastic and 30 non-neoplastic). All participants evaluated these images to assess baseline accuracy, sensitivity, specificity, and positive and negative predictive values of polyp histology prediction. Each endoscopist was trained with the BLI classification from the BLI teaching website. Results were compared between trainees and experts regarding both interobserver agreement in each individual BASIC descriptor.

    Results Experts achieved significantly more precise results in the prediction of more advanced histology (adenoma), as compared to trainees as follows in accuracy, sensitivity, specificity, PPV and NPV: 93,03% vs. 72,95%, 92,74% vs. 58,07%, 93.34% vs 88,34%, 93,85% vs. 83,49% and 93,09% vs. 67,82%, respectively. The interobserver level of agreement was good (K = 0.85) in the experienced cohort and weak (K = 0.45) in the trainee group.

    Conclusions BLI combined with optical zoom technology is a useful tool for precise optical diagnosis of polyp histology to support the resect-and-discard strategy. The clinical application of BASIC with an adequate assessment of different predictors necessitates chromoendoscopic expertise, but in contrast non-expert trainee endoscopist get little aid from BASIC to get better differential diagnosis


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