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Narrow-band imaging comparable to white light colonoscopy in differentiating colorectal polyps
Date:12/15/2008

recancerous potential.

"In this prospective trial, we aimed to compare standard broadband white light colonoscopy with narrow-band imaging for the differentiation of colorectal polyps during real-time colonoscopy by using a modified Kudo pit pattern classification and vascular color intensity grading," said study lead author Jason Rogart, MD, Yale University School of Medicine, New Haven, Conn. "Overall, NBI accuracy was 80 percent, compared with 77 percent for white light alone. We also demonstrated that improved performance can be achieved over time. NBI was most useful in correctly identifying adenomas, polyps that have the most risk of developing into cancer, especially those that are small." The authors went on to state that this is, to their knowledge, the largest study to date that addresses the question of whether NBI outperforms ordinary white light in predicting the histopathologic diagnosis of polyps during real-time colonoscopy.

Patients and Methods

A total of 302 patients were enrolled from August 2006 to July 2007 at Yale University; 265 polyps were found in 131 patients resulting in an adenoma detection rate of 30 percent. Of the polyps, 49 percent were adenomas or carcinomas, whereas 51 percent were nonadenomatous; 74 percent of adenomas were 5 mm or smaller, and 42 percent were 3 mm or smaller.

Four experienced endoscopists, with a minimum number of 1,000 colonoscopies previously performed (range 1,000-10,000), participated in this study. All colonoscopies were performed with high definition endoscopes. The participating physicians were oriented to NBI before enrollment through a one-hour interactive lecture on NBI, instruction in classifying polyps based on the surface characteristics (simplified Kudo pit pattern and vascular color intensity grading), and a pretest that consisted of 20 unknown polyps photographed with the NBI system. Additionally, an atlas of endoscopic images of polyps examined with b
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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