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

oth chromoendoscopy and NBI were posted in the procedure areas.

Throughout the study period, endoscopists received feedback every two weeks about the accuracy of their endoscopic predictions compared with the histopathologic diagnosis. After enrollment was completed, the same endoscopists completed a posttest that involved the same 20 unknown polyps, which were randomly reordered. Before initiating the study, researchers planned to assess endoscopists' individual and group accuracy in the first and second halves of the study. The halfway point in the study was determined after completion of study enrollment by dividing in half the total number of polyps removed by each endoscopist.

Results

Overall, NBI accuracy was 80 percent compared with 77 percent for white light alone. NBI performed significantly better than white light in diagnosing adenomas (sensitivity 80 percent vs. 69 percent), particularly for adenomas ≤ 5 mm (75 percent vs. 60 percent). There was no difference between NBI and white light for nonadenomatous polyps. Diagnostic accuracies were better for larger polyps (mean size of correct prediction 4.7 mm vs. 3.9 mm) and nonsignificant for polypoid shape (87 percent vs. 79 percent for polyps with sessile shape). Compared with white light, however, NBI did not significantly improve accuracy in any size or shape category, nor for any segment of the colon.

An equal number of polyps were analyzed in each of the two study periods (133 and 132, respectively). NBI accuracies significantly improved from 74 percent to 87 percent between the two study periods whereas, white light accuracies were unchanged (78 percent first half and 79 percent second half). In the second half of the study (i.e., after the learning curve was reached), therefore, NBI was significantly more accurate than white light.

Researchers demonstrated that there is a learning curve with regard to NBI assessment of colorectal polyps, and t
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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