Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification

Journal article

Publication Details

Author(s): Subramaniam S, Hayee B, Aepli P, Schoon E, Stefanovic M, Kandiah K, Thayalasekaran S, Alkandari A, Bassett P, Coron E, Pech O, Hassan C, Neumann H, Bisschops R, Repici A, Bhandari P
Journal: United European Gastroenterology Journal
Publication year: 2019
Volume: 7
Journal issue: 2
Pages range: 316-325
ISSN: 2050-6406
eISSN: 2050-6414


Background Blue Light Imaging (BLI) is a new imaging technology that enhances mucosal surface and vessel patterns. A specific BLI classification was recently developed to enable better characterisation of colorectal polyps (BLI Adenoma Serrated International Classification (BASIC)). The aim of this study was to validate the diagnostic performance of BASIC in predicting polyp histology in experienced and trainee endoscopists. Methods Five experienced and five trainee endoscopists evaluated high-definition white light (HDWL) and BLI images from 45 small polyps to assess baseline accuracy, sensitivity, specificity, and positive and negative predictive values (NPVs) of polyp histology. Each endoscopist was trained with the BLI classification before repeating the exercise. Results were compared pre- and post-training. Results The overall pre-training accuracy improved from 87% to 94%. The sensitivity and NPV of adenoma diagnosis also improved significantly from 79% to 96% and 81% to 95% with BASIC training. This improvement was noted in both groups. The interobserver level of agreement was very good (K = 0.90) in the experienced cohort and good (K = 0.66) in the trainee group post-training. Conclusions BLI is a useful tool for optical diagnosis, and the use of BASIC with adequate training can significantly improve the accuracy, sensitivity and NPV of adenoma diagnosis.

External institutions with authors

Catharina Hospital / Catharina Ziekenhuis
Diagnostični center Bled
Istituto Clinico Humanitas
King's College Hospital (KCH)
Krankenhaus Barmherzige Brüder, Academic Teaching Hospital of University Medical Center Regensburg
Luzerner Kantonsspital
Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU)
Ospedale Nuovo Regina Margherita
Queen Alexandra Hospital
Statsconsultancy Ltd
University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven

How to cite

Subramaniam, S., Hayee, B., Aepli, P., Schoon, E., Stefanovic, M., Kandiah, K.,... Bhandari, P. (2019). Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification. United European Gastroenterology Journal, 7(2), 316-325. https://dx.doi.org/10.1177/2050640618822402

Subramaniam, Sharmila, et al. "Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification." United European Gastroenterology Journal 7.2 (2019): 316-325.


Last updated on 2019-21-03 at 22:08