Skip to content
2000
image of Inter-rater Reliability and Accuracy of NBI Score for Activity Evaluation in Ulcerative Colitis
file format pdf download PDF

Abstract

Introduction

Colonoscopy is a critical tool for the management of Ulcerative Colitis (UC). In this study, we aim to explore the accuracy of Virtual Chromoendoscopy (VCE) using Narrow Banding Imaging (NBI), and magnification using Near Focus (NF) for a better definition of endoscopic inflammation grade in UC patients compared to standard white light (WL) endoscopy alone.

Methods

This is a non-randomized prospective study including all the patients who underwent a colonoscopy (for any reason) between April and September 2023 (with protocol number n. 60/2019.20). During the endoscopic evaluation, at least one image with white light - evaluated using the Mayo Endoscopic Score (MES), one image with NBI, one image with NBI plus NF, and a biopsy were obtained in each colonic tract (cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum). All the stored images were evaluated by three endoscopists separately and compared with the results of the histological evaluation.

Results

A total of 31 UC patients were included. The inter-rater reliability concerning the different scores used (MES, NBI score, and NBI plus NF score), which was evaluated with Cohen's kappa coefficient, was good for the MES, good to excellent for the NBI score, and good for the NBI plus NF score. The concordance between histological evaluation (using the Nancy Index) and the MES was unsatisfactory for all the endoscopists, while the concordance between the NBI evaluation score and the Nancy Index was good to excellent.

Discussion

The reported results demonstrated both the inter-rater reliability and diagnostic accuracy of NBI in assessing endoscopic disease activity. The high inter-operator agreement, ranging from good to excellent, further supports the feasibility and consistency of NBI as a practical tool.

Conclusion

The results in the present study suggest that the new endoscopic technologies could be useful to better define disease activity in Inflammatory Bowel Disease (IBD) patients driving better therapeutic strategy.

© 2025 The Author(s). Published by Bentham Science Publisher. 
This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode.
Loading

Article metrics loading...

/content/journals/rrct/10.2174/0115748871367645250623062144
2025-07-03
2025-09-14

  • From This Site

    /content/journals/rrct/10.2174/0115748871367645250623062144
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

/deliver/fulltext/rrct/10.2174/0115748871367645250623062144/BMS-RRCT-2024-135.html?itemId=/content/journals/rrct/10.2174/0115748871367645250623062144&mimeType=html&fmt=ahah

References

  1. Magro F. Gionchetti P. Eliakim R. Ardizzone S. Armuzzi A. Barreiro-de Acosta M. Burisch J. Gecse K.B. Hart A.L. Hindryckx P. Langner C. Limdi J.K. Pellino G. Zagórowicz E. Raine T. Harbord M. Rieder F. Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J. Crohn’s Colitis 2017 11 6 649 670 10.1093/ecco‑jcc/jjx008 28158501
    [Google Scholar]
  2. Peyrin-Biroulet L. Sandborn W. Sands B.E. Reinisch W. Bemelman W. Bryant R.V. D’Haens G. Dotan I. Dubinsky M. Feagan B. Fiorino G. Gearry R. Krishnareddy S. Lakatos P.L. Loftus E.V. Jr Marteau P. Munkholm P. Murdoch T.B. Ordás I. Panaccione R. Riddell R.H. Ruel J. Rubin D.T. Samaan M. Siegel C.A. Silverberg M.S. Stoker J. Schreiber S. Travis S. Van Assche G. Danese S. Panes J. Bouguen G. O’Donnell S. Pariente B. Winer S. Hanauer S. Colombel J.F. Selecting therapeutic targets in inflammatory bowel disease (STRIDE): Determining therapeutic goals for treat-to-target. Am. J. Gastroenterol. 2015 110 9 1324 1338 10.1038/ajg.2015.233 26303131
    [Google Scholar]
  3. Solitano V. D’Amico F. Allocca M. Fiorino G. Zilli A. Loy L. Gilardi D. Radice S. Correale C. Danese S. Peyrin-Biroulet L. Furfaro F. Rediscovering histology: What is new in endoscopy for inflammatory bowel disease? Therap. Adv. Gastroenterol. 2021 14 17562848211005692 10.1177/17562848211005692 33948114
    [Google Scholar]
  4. Nardone O.M. Cannatelli R. Zardo D. Ghosh S. Marietta I. Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease? Therap. Adv. Gastroenterol. 2019 12 1756284819863015 10.1177/1756284819863015 31360224
    [Google Scholar]
  5. Mathy C. Schneider K. Chen Y.Y. Varma M. Terdiman J.P. Mahadevan U. Gross versus microscopic pancolitis and the occurrence of neoplasia in ulcerative colitis. Inflamm. Bowel Dis. 2003 9 6 351 355 10.1097/00054725‑200311000‑00002 14671483
    [Google Scholar]
  6. Rutter M. Saunders B. Wilkinson K. Rumbles S. Schofield G. Kamm M. Williams C. Price A. Talbot I. Forbes A. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenterology 2004 126 2 451 459 10.1053/j.gastro.2003.11.010 14762782
    [Google Scholar]
  7. Yoon H. Jangi S. Dulai P.S. Boland B.S. Prokop L.J. Jairath V. Feagan B.G. Sandborn W.J. Singh S. Incremental benefit of achieving endoscopic and histologic remission in patients with ulcerative colitis: A systematic review and meta-analysis. Gastroenterology 2020 159 4 1262 1275.e7 10.1053/j.gastro.2020.06.043 32585306
    [Google Scholar]
  8. Viscido A. Valvano M. Stefanelli G. Capannolo A. Castellini C. Onori E. Ciccone A. Vernia F. Latella G. Systematic review and meta-analysis: The advantage of endoscopic Mayo score 0 over 1 in patients with ulcerative colitis. BMC Gastroenterol. 2022 22 1 92 10.1186/s12876‑022‑02157‑5 35240984
    [Google Scholar]
  9. Travis S.P.L. Higgins P.D.R. Orchard T. Van Der Woude C.J. Panaccione R. Bitton A. O’Morain C. Panés J. Sturm A. Reinisch W. Kamm M.A. D’Haens G. Review article: Defining remission in ulcerative colitis. Aliment. Pharmacol. Ther. 2011 34 2 113 124 10.1111/j.1365‑2036.2011.04701.x 21615435
    [Google Scholar]
  10. Subramanian V. Ramappa V. Telakis E. Mannath J. Jawhari A.U. Hawkey C.J. Ragunath K. Comparison of high definition with standard white light endoscopy for detection of dysplastic lesions during surveillance colonoscopy in patients with colonic inflammatory bowel disease. Inflamm. Bowel Dis. 2013 19 2 350 355 10.1002/ibd.23002 22552948
    [Google Scholar]
  11. Zhang Y. Chen H.Y. Zhou X.L. Pan W.S. Zhou X.X. Pan H.H. Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis. World J. Gastroenterol. 2020 26 40 6279 6294 10.3748/wjg.v26.i40.6279 33177800
    [Google Scholar]
  12. Desai M. Boregowda U. Srinivasan S. Kohli D.R. Al Awadhi S. Murino A. Yu L.H.K. Dinis-Ribeiro D.M. Sharma P. Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta-analysis. J. Gastroenterol. Hepatol. 2021 36 8 2038 2046 10.1111/jgh.15564 34090306
    [Google Scholar]
  13. Wanders L.K. Dekker E. Pullens B. Bassett P. Travis S.P.L. East J.E. Cancer risk after resection of polypoid dysplasia in patients with longstanding ulcerative colitis: A meta-analysis. Clin. Gastroenterol. Hepatol. 2014 12 5 756 764 10.1016/j.cgh.2013.07.024 23920032
    [Google Scholar]
  14. Matsumoto T. Kudo T. Jo Y. Esaki M. Yao T. Iida M. Magnifying colonoscopy with narrow band imaging system for the diagnosis of dysplasia in ulcerative colitis: A pilot study. Gastrointest. Endosc. 2007 66 5 957 965 10.1016/j.gie.2007.04.014 17826773
    [Google Scholar]
  15. von Elm E. Altman D.G. Egger M. Pocock S.J. Gøtzsche P.C. Vandenbroucke J.P. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Int. J. Surg. 2014 12 12 1495 1499 10.1016/j.ijsu.2014.07.013 25046131
    [Google Scholar]
  16. Maaser C. Sturm A. Vavricka S.R. Kucharzik T. Fiorino G. Annese V. Calabrese E. Baumgart D.C. Bettenworth D. Borralho Nunes P. Burisch J. Castiglione F. Eliakim R. Ellul P. González-Lama Y. Gordon H. Halligan S. Katsanos K. Kopylov U. Kotze P.G. Krustiņš E. Laghi A. Limdi J.K. Rieder F. Rimola J. Taylor S.A. Tolan D. van Rheenen P. Verstockt B. Stoker J. ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J. Crohn’s Colitis 2019 13 2 144 164K 10.1093/ecco‑jcc/jjy113 30137275
    [Google Scholar]
  17. Hassan C. East J. Radaelli F. Spada C. Benamouzig R. Bisschops R. Bretthauer M. Dekker E. Dinis-Ribeiro M. Ferlitsch M. Fuccio L. Awadie H. Gralnek I. Jover R. Kaminski M.F. Pellisé M. Triantafyllou K. Vanella G. Mangas-Sanjuan C. Frazzoni L. Van Hooft J.E. Dumonceau J.M. Bowel preparation for colonoscopy: European society of gastrointestinal endoscopy (ESGE) guideline – Update 2019. Endoscopy 2019 51 8 775 794 10.1055/a‑0959‑0505 31295746
    [Google Scholar]
  18. Rembacken B. Hassan C. Riemann J. Chilton A. Rutter M. Dumonceau J.M. Omar M. Ponchon T. Quality in screening colonoscopy: Position statement of the European Society of Gastrointestinal Endoscopy (ESGE). Endoscopy 2012 44 10 957 968 10.1055/s‑0032‑1325686 22987217
    [Google Scholar]
  19. Satsangi J. Silverberg M.S. Vermeire S. Colombel J.F. The Montreal classification of inflammatory bowel disease: Controversies, consensus, and implications. Gut 2006 55 6 749 753 10.1136/gut.2005.082909 16698746
    [Google Scholar]
  20. Sturm A. Maaser C. Calabrese E. Annese V. Fiorino G. Kucharzik T. Vavricka S.R. Verstockt B. van Rheenen P. Tolan D. Taylor S.A. Rimola J. Rieder F. Limdi J.K. Laghi A. Krustiņš E. Kotze P.G. Kopylov U. Katsanos K. Halligan S. Gordon H. González Lama Y. Ellul P. Eliakim R. Castiglione F. Burisch J. Borralho Nunes P. Bettenworth D. Baumgart D.C. Stoker J. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 2: IBD scores and general principles and technical aspects. J. Crohn’s Colitis 2019 13 3 273 284 10.1093/ecco‑jcc/jjy114 30137278
    [Google Scholar]
  21. Bhat Y.M. Abu Dayyeh B.K. Chauhan S.S. Gottlieb K.T. Hwang J.H. Komanduri S. Konda V. Lo S.K. Manfredi M.A. Maple J.T. Murad F.M. Siddiqui U.D. Banerjee S. Wallace M.B. High-definition and high-magnification endoscopes. Gastrointest. Endosc. 2014 80 6 919 927 10.1016/j.gie.2014.06.019 25442091
    [Google Scholar]
  22. Singh R. Shahzad M.A. Tam W. Goda K. Yu L.H.K. Fujishiro M. Uedo N. Ruszkiewicz A. Preliminary feasibility study using a novel narrow-band imaging system with dual focus magnification capability in B arrett’s esophagus: Is the time ripe to abandon random biopsies? Dig. Endosc. 2013 25 S2 151 156 10.1111/den.12106 23617668
    [Google Scholar]
  23. Wong Kee Song L.M. Adler D.G. Conway J.D. Diehl D.L. Farraye F.A. Kantsevoy S.V. Kwon R. Mamula P. Rodriguez B. Shah R.J. Tierney W.M. Narrow band imaging and multiband imaging. Gastrointest. Endosc. 2008 67 4 581 589 10.1016/j.gie.2008.01.013 18374021
    [Google Scholar]
  24. Subramanian V. Mannath J. Hawkey C. Ragunath K. High definition colonoscopy vs. standard video endoscopy for the detection of colonic polyps: A meta-analysis. Endoscopy 2011 43 6 499 505 10.1055/s‑0030‑1256207 21360420
    [Google Scholar]
  25. Mohammed Vashist N. Samaan M. Mosli M.H. Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis. Coch. Database Syst. Rev. 2018 2018 1 CD011450 10.1002/14651858.CD011450.pub2
    [Google Scholar]
  26. Trivedi P.J. Kiesslich R. Hodson J. Bhala N. Boulton R.A. Cooney R. Gui X. Iqbal T. Li K. Mumtaz S. Pathmakanthan S. Quraishi M.N. Sagar V.M. Shah A. Sharma N. Siau K. Smith S. Ward S. Widlak M.M. Bisschops R. Ghosh S. Iacucci M. The paddington international virtual chromoendoscopy score in ulcerative colitis exhibits very good inter-rater agreement after computerized module training: A multicenter study across academic and community practice (with video). Gastrointest. Endosc. 2018 88 1 95 106.e2 10.1016/j.gie.2018.02.044 29548940
    [Google Scholar]
  27. Guo T. Qian J.M. Yang A.M. Li Y. Zhou W.X. Narrow-band Imaging colonoscopy to assess mucosal angiogenesis in ulcerative colitis. Gastroenterol. Res. Pract. 2019 2019 1 7 10.1155/2019/8312624 30918516
    [Google Scholar]
  28. Marchal-Bressenot A. Salleron J. Boulagnon-Rombi C. Bastien C. Cahn V. Cadiot G. Diebold M.D. Danese S. Reinisch W. Schreiber S. Travis S. Peyrin-Biroulet L. Development and validation of the Nancy histological index for UC. Gut 2017 66 1 43 49 10.1136/gutjnl‑2015‑310187 26464414
    [Google Scholar]
  29. Cohen J. Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. Psychol. Bull. 1968 70 4 213 220 10.1037/h0026256 19673146
    [Google Scholar]
  30. Shah J. Dutta U. Das A. Sharma V. Mandavdhare H. Sharma P. Kalsi D. Popli P. Kochhar R. Relationship between Mayo endoscopic score and histological scores in ulcerative colitis: A prospective study. JGH Open 2020 4 3 382 386 10.1002/jgh3.12260 32514441
    [Google Scholar]
/content/journals/rrct/10.2174/0115748871367645250623062144
Loading
Inter-rater Reliability and Accuracy of NBI Score for Activity Evaluation in Ulcerative Colitis
Bentham Science Publishers ; https://doi.org/10.2174/0115748871367645250623062144
/content/journals/rrct/10.2174/0115748871367645250623062144
/content/journals/rrct/10.2174/0115748871367645250623062144
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: virtual chromoendoscopy ; Inflammatory bowel disease ; endoscopy ; ulcerative colitis ; narrow banding imaging (NBI)

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test