Prospective Evaluation of the Accuracy of A Training Program in Image Recognition by Narrow-Band Imaging Guided Hysteroscopy of Endometrial Neoplasms

Abstract

Introduction: Narrow-band imaging (NBI) hysteroscopy by experienced hysteroscopists (EH) is useful for diagnosing endometrial neoplasms.

Objective: We investigated whether the diagnostic reliability of NBI could be improved by specific professional training.

Methods: Three levels of trainees who were Surgeons at our hospital were selected. Level I: 6 trainees had no prior hysteroscopic experience; level II: 6 trainees had experience with <100 cases; and level III: 6 trainees had <500 cases. The two-hour training program for white light hysteroscopy (WLH) and NBI included information on the classifications of diseases of the uterine cavity and on the features of diagnostic images. Images from 529 patients were evaluated independently by trainees with 3 levels of before and after training, and by EH. Trainees and EHs had to analyze and arrive at a hysteroscopic diagnosis for each image that was compared to the pathological diagnosis for diagnostic accuracy.

Results: After training, all levels achieved higher diagnostic accuracy with NBI than was seen with WLH. Level III trainees achieved diagnostic accuracy and kappa values for NBI that were equivalent to those of EH.

Conclusions: Training can increase the diagnostic skill of all trainees using NBI, especially for trainees with prior hysteroscopic experience.

Keywords: Diagnostic accuracy; Endometrial pathologies; Hysteroscopy; Narrow-band imaging; Uterine cavity.