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蓝光成像和联动成像技术可提高非专家组内镜医师对巴雷特肿瘤的观察
蓝光成像和联动成像技术可提高非专家组内镜医师对巴雷特肿瘤的观察
蓝光成像和联动成像技术可提高非专家组内镜医师对巴雷特肿瘤的观察
Blue-light imaging and linked-color imaging improve visualization of Barrett's neoplasia by nonexpert endoscopists
AJ de Groof, KN Fockens, MR Struyvenberg… - Gastrointestinal Endoscopy, 2020
当非专家组内镜医师使用BLI和LCI时,对Barrett肿瘤的可见性有显著的附加价值。评估人员对增加BLI和LCI的评价优于单独使用WLE。此外,这一添加导致了更好的描绘性能,从而允许更好地获取目标活检样本。
Conclusions: The use of BLI and LCI has significant additional value for the visualization of Barrett's neoplasia when used by nonexpert endoscopists. Assessors appreciated the addition of BLI and LCI better than the use of WLE alone. Furthermore, this addition led to improved delineation performance, thereby allowing for better acquisition of targeted biopsy samples.
01
背景和目的
内镜下识别早期巴雷特肿瘤是一个挑战。蓝光成像(BLI)和联动成像技术(LCI)或许可以帮助内镜医师鉴别肿瘤。我们的目的是评价非专家组内镜医师观察与评估巴雷特肿瘤时,比较BLI和LCI与单纯的白光内镜检查(WLE)的可见性。
Background and aims: Endoscopic recognition of early Barrett's neoplasia is challenging. Blue-light imaging (BLI) and linked-color imaging (LCI) may assist endoscopists in appreciation of neoplasia. Our aim was to evaluate BLI and LCI for visualization of Barrett's neoplasia in comparison with white-light endoscopy (WLE) alone, when assessed by nonexpert endoscopists.
02
方法
在这项基于网络的评估中,由3名内镜专家对30例Barrett肿瘤病变进行相应的WLE、BLI和LCI图像的划定,以确定基本事实。然后由来自3个国家的76名具有不同专业水平的非专家组内镜医师对这些图像进行评分和描述,分为4个独立的评估阶段,洗脱期为2周。评估结果如下:评估1,仅WLE;评估2,WLE + BLI;评估3,WLE + LCI;评估4,WLE + BLI + LCI。结果如下:(1)对宏观外观的评价和勾画病变的能力(视觉模拟评分[VAS]评分);(2)首选技术(顺序得分);(3)评估人员的描述表现与专家的真实情况有重叠。
Methods: In this web-based assessment, corresponding WLE, BLI, and LCI images of 30 neoplastic Barrett's lesions were delineated by 3 expert endoscopists to establish ground truth. These images were then scored and delineated by 76 nonexpert endoscopists from 3 countries and with different levels of expertise, in 4 separate assessment phases with a washout period of 2 weeks. Assessments were as follows: assessment 1, WLE only; assessment 2, WLE + BLI; assessment 3, WLE + LCI; assessment 4, WLE + BLI + LCI. The outcomes were (1) appreciation of macroscopic appearance and ability to delineate lesions (visual analog scale [VAS] scores); (2) preferred technique (ordinal scores); and (3) assessors' delineation performance in terms of overlap with expert ground truth.
03
结果
2 - 4期的中位VAS评分显著高于1期(P < .001)。在评价宏观外观(P < .001)和轮廓(P < .001)方面,评估者更喜欢BLI和LCI,而不是WLE。线性混合效应模型表明,在第4阶段,描绘性能显著提高。
Results: Median VAS scores for phases 2 to 4 were significantly higher than in phase 1 (P < .001). Assessors preferred BLI and LCI over WLE for appreciation of macroscopic appearance (P < .001) and delineation (P < .001). Linear mixed-effect models showed that delineation performance increased significantly in phase 4.
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