Narrow Band Imaging by Novice Raters After Short Training: A Pilot Feasibility Study of Diagnostic Accuracy and...

Area of Science:

• Oral pathology and diagnostics
• Medical imaging interpretation
• Dental education

Background:

• Accurate diagnosis of oral lesions is crucial for effective treatment.
• Narrow-band imaging (NBI) offers enhanced visualization of mucosal microvasculature.
• The Takano NBI-based IPCL classification system aims to standardize NBI interpretation.

Purpose of the Study:

• To evaluate the feasibility, diagnostic accuracy, and repeatability of the Takano NBI-based IPCL classification.
• To assess the performance of novice raters after brief formal training.
• To determine the reliability of NBI interpretation for oral lesions by inexperienced practitioners.

Main Methods:

• Ten dental students classified 90 oral lesions using white-light and NBI images over two sessions.
• Lesions were scored on an ordinal scale (0-4) based on visual characteristics.
• Histopathology served as the gold standard for diagnosis.

Main Results:

• Mean agreement with histology was low (18.8%-21.0%), with poor weighted kappa values (0.080-0.093).
• Agreement with an expert rater was also limited (20.4%-22.2%), with low kappa values (0.127-0.170).
• These results indicate poor diagnostic accuracy and repeatability among novice raters.

Conclusions:

• A short, lecture-based training is inadequate for novice raters to reliably interpret NBI images using the Takano classification.
• Competency-based training and supervised case libraries are necessary before NBI assessment can be recommended for inexperienced clinicians.
• Further research into effective training methodologies for NBI interpretation is warranted.