{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:55Z","timestamp":1787014075873,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Endoscopic biopsies for nonampullary duodenal epithelial neoplasms (\n                      <jats:styled-content style=\"fixed-case\">NADEN<\/jats:styled-content>\n                      s) can induce submucosal fibrosis, making endoscopic resection difficult. However, no biopsy\u2010free method exists to distinguish between\n                      <jats:styled-content style=\"fixed-case\">NADEN<\/jats:styled-content>\n                      s and non\u2010neoplasms. We developed a diagnostic algorithm for duodenal neoplasms based on magnifying endoscopy findings and evaluated the model's diagnostic ability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Magnified endoscopic images and duodenal lesion histology were collected consecutively between January 2015 and April 2016. Diagnosticians classified the surface patterns as pit, groove or absent. In cases of nonvisible surface patterns, the vascular pattern was evaluated to determine regularity or irregularity. The correlation between our algorithm (pit\u2010type or absent with irregular vascular pattern) and the lesion histology were evaluated. Four evaluators, who were blinded to the histology, also classified the endoscopic findings and evaluated the diagnostic performance and interobserver agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Endoscopic images of 114 lesions were evaluated (70\n                      <jats:styled-content style=\"fixed-case\">NADEN<\/jats:styled-content>\n                      s and 44 non\u2010neoplasms, 31 in the superior and 83 in the descending and horizontal duodenum). Of the\n                      <jats:styled-content style=\"fixed-case\">NADEN<\/jats:styled-content>\n                      surface patterns, 88% (62\/70) were pit\u2010type, while 79% (35\/44) of the non\u2010neoplasm surface patterns were groove\u2010type. Our diagnostic algorithm for differentiating\n                      <jats:styled-content style=\"fixed-case\">NADEN<\/jats:styled-content>\n                      s from non\u2010neoplasms was high (sensitivity 96%, specificity 95%) in the descending and horizontal duodenum. The evaluators\u2019 diagnostic performances were also high, and interobserver agreement for the algorithm was good between each diagnostician and evaluator (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u00a0=\u00a00.60\u20130.76).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diagnostic performance of our algorithm sufficiently enabled eliminating endoscopic biopsies for diagnosing the descending and horizontal duodenum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.13485","type":"journal-article","created":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T22:23:26Z","timestamp":1563229406000},"page":"84-95","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Differentiation between duodenal neoplasms and non\u2010neoplasms using magnifying narrow\u2010band imaging \u2013 Do we still need biopsies for duodenal lesions?"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-9863","authenticated-orcid":false,"given":"Yasushi","family":"Yamasaki","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan"},{"name":"Department of Gastroenterology Okayama University Hospital Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-298X","authenticated-orcid":false,"given":"Yoji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kanesaka","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7721-8292","authenticated-orcid":false,"given":"Taro","family":"Iwatsubo","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomofumi","family":"Akasaka","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noboru","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Higashino","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology Osaka International Cancer Institute Osaka 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