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Accuracy of narrow band imaging with colonoscopy allows for distal non-cancerous polyps to be left in place
Date:8/27/2012

could transform the clinical approach to management of diminutive colorectal polyps. Currently, diminutive colorectal polyps, less than or equal to 5 mm, are removed endoscopically and submitted for pathologic assessment. The pathologic assessment is used to guide post-polypectomy surveillance intervals. However, these polyps rarely harbor invasive cancer and seldom have high risk features such as villous elements or high-grade dysplasia," said study lead author Douglas K. Rex, MD, FASGE, Indiana University Hospital, Indianapolis. "We evaluated the feasibility of using NBI high-definition colonoscopes for leaving distal colon hyperplastic polyps in place during colonoscopy. We found very high levels of accuracy can be achieved for the endoscopic prediction of polyp type in the distal colon. Leaving distal colon hyperplastic polyps in place may be a relatively easy goal to achieve with acceptable accuracy by using narrow band imaging."

Methods
The reseachers' objectives were to assess the accuracy of predicting histology (tissue composition or polyp type) by using narrow band imaging in real time for distal colorectal polyps. It was a prospective, observational study conducted at Indiana University Hospital and their affiliated ambulatory surgery center. The study involved 225 consecutive adults undergoing elective screening or surveillance colonoscopy. Researchers evaluated real-time histology of 235 distal colorectal polyps from 31 patients by using high-definition colonoscopy and NBI without optical magnification. For each polyp, the endoscopist described size and surface characteristics (vascular and pit pattern, color, pseudodepression). Before removal, histology was predicted, and a level of confidence (high or low) was assigned. The main outcome measurements were sensitivity and negative predictive value of high-confidence endoscopic predictions of adenomatous versus hyperplastic histology for polyps less than or equal to 5 mm in size.
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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