High Accuracy of Narrow Band Imaging Without Magnification for the Real-Time Characterization of Polyp Histology and Its Comparison With High-Definition White Light Colonoscopy: A Prospective Study

Rastogi, Amit; Keighley, John; Singh, Vikas; Callahan, Peggy; Bansal, Ajay; Wani, Sachin; Sharma, Prateek
October 2009
American Journal of Gastroenterology;Oct2009, Vol. 104 Issue 10, p2422
Academic Journal
OBJECTIVES:Standard white light colonoscopy has limited ability to differentiate between polyp types (adenomatous vs. hyperplastic). Narrow band imaging (NBI) highlights the superficial mucosal/vascular patterns on polyps and may facilitate real-time characterization of polyp histology. The aim of this study was to prospectively evaluate and compare the diagnostic characteristics of high-definition white light colonoscopy (HDWL) and NBI without magnification in the real-time prediction of polyp histology (adenomatous vs. hyperplastic) by evaluating the surface mucosal and vascular patterns.METHODS:We conducted a prospective comparative study in a tertiary referral center. A total of 100 patients referred for screening or surveillance colonoscopy were prospectively enrolled and underwent colonoscopy using a high-definition colonoscope with NBI capability. Every polyp detected was initially evaluated with HDWL followed by NBI for the presence of surface mucosal/vascular patterns. Based on these patterns, polyp histology was predicted by both modalities. The main outcome measurements were: (i) diagnostic characteristics of HDWL and NBI in predicting polyp histology and (ii) impact of polyp size and learning effect (first half of study vs. second half) on the ability of NBI to predict adenomas.RESULTS:A total of 236 polyps were detected in 100 patients—143 adenomas, 77 hyperplastic, and 16 others. Surface patterns (type A: hyperplastic; type B: adenomatous) were recognized in all polyps with NBI (100%) compared to 45% with HDWL. For predicting adenomas, NBI had a significantly higher sensitivity and greater accuracy (96 and 93% respectively) compared with HDWL (38 and 61% respectively) (all P<0.0001). Although the accuracy of NBI for predicting adenomas improved with increasing polyp size (≤5 mm; 6–9 mm; ≥10 mm) and in the second half compared with the first half of the study, these differences were not statistically significant.CONCLUSIONS:Using a simple surface mucosal/vascular pattern classification, NBI without magnification was highly accurate and significantly superior to HDWL for the real-time prediction of adenomas.


Related Articles

  • Wide angle colonoscopy with a prototype instrument: impact on miss rates and efficiency as determined by back-to-back colonoscopies. Rex, Douglas K.; Chadalawada, Vidyasree; Helper, Debra J. // American Journal of Gastroenterology;Sep2003, Vol. 98 Issue 9, p2000 

    : ObjectivePolyps are missed during conventional colonoscopy, even with meticulous technique. The aim of this study was to investigate whether a prototype wide angle colonoscope is associated with a reduced miss rate for polyps.: MethodsTwo studies were performed. In study 1, a total of 50...

  • Colorectal cancer is reliably excluded in the frail and elderly population by minimal preparation CT. Saunders, J.; Miskovic, D.; Bowman, C.; Panto, P.; Menon, A. // Techniques in Coloproctology;Feb2014, Vol. 18 Issue 2, p137 

    Background: This study aimed to retrospectively assess the accuracy of minimal preparation computed tomography (MPCT) in the detection of colorectal cancer (CRC) within the frail and elderly population and to evaluate the relevance of extra-colonic findings (ECF). Methods: Radiology reports,...

  • Standard, high-definition colonoscopy detection rates similar in community setting.  // Hem/Onc Today;1/10/2013, Vol. 14 Issue 1, p8 

    The article discusses the results of a study by digestive disease specialist Asheesh Ray of Missouri, that compared standard-definition colonoscopies (SDC) and high-definition colonoscopies (HDC) which found that HDC was not able to significantly improve adenoma or polyp detection rates over SDC.

  • Colonoscopy adenoma detection rate predicted risk for interval colorectal cancer. Cona, Christen; Harris, Jason; Southall, Jennifer // Hem/Onc Today;6/10/2010, Vol. 11 Issue 11, p25 

    The article discusses research published in a 2010 issue of the "New England Journal of Medicine," which found that link between colonoscopy adenoma detection rate and risk for interval colorectal cancer.

  • Narrow band imaging for colonoscopic surveillance in hereditary non-polyposis colorectal cancer. East, J. E.; Suzuki, N.; Stavrinidis, M.; Guenther, I.; Thomas, H. J. W.; Saunders, B. P. // Gut;Jan2008, Vol. 57 Issue 1, p65 

    Background: Colonoscopic surveillance for hereditary non-polyposis colorectal cancer (HNPCC) reduces death rates, but early interval cancers still occur, probably due to missed small, aggressive adenomas. Narrow band imaging (NBI), a novel endoscopic technology, highlights superficial mucosal...

  • Trainees' adenoma detection rate is higher if ≥10 minutes is spent on withdrawal during colonoscopy. Gromski, Mark; Miller, Christopher; Lee, Suck-Ho; Park, Eun; Lee, Tae; Park, Sang-Heum; Chung, Il-Kwun; Kim, Sun-Joo; Hwangbo, Young // Surgical Endoscopy;May2012, Vol. 26 Issue 5, p1337 

    Background: It has been demonstrated that prolonged colonoscopic withdrawal times (WT; >6 min) are beneficial for the adenoma detection rate (ADR) for experienced endoscopists. There are little data, however, to guide the appropriate colonoscopic withdrawal times for trainees. The purpose of...

  • ADENOMA MARKERS OR BUSY WORK? Johnson, David A.; Cattau Jr., Edward L. // American Journal of Gastroenterology;Jun1991, Vol. 86 Issue 6, p783 

    Presents an abstract concerning the risk for colon adenomas in patients with rectosigmoid hyperplastic polyps. Prevalence of proximal adenomas in patients without distal hyperplastic polyps; Association of rectosigmoid adenomas with proximal adenomas; Limitation in the administration of...

  • Endoscopic colorectal cancer screening: screening modality vs. screening interval. Kessler, William R.; Nehme, Omar S. // American Journal of Gastroenterology;Dec2003, Vol. 98 Issue 12, p2796 

    In this study by Shoen et al., the benefit of repeat sigmoidoscopy performed 3 yr after a negative examination was assessed. The patient population was composed of participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). The mean age was 65.7 yr and 61.6% were...

  • Findings on Optical Colonoscopy After Positive CT Colonography Exam. Cornett, Daniel; Barancin, Courtney; Roeder, Brent; Reichelderfer, Mark; Frick, Terrance; Gopal, Deepak; Kim, David; Pickhardt, Perry J.; Taylor, Andrew; Pfau, Patrick // American Journal of Gastroenterology;Aug2008, Vol. 103 Issue 8, p2068 

    BACKGROUND & AIMS: The aim of this study is to evaluate the findings on optical colonoscopy (OC) after a positive CT colonography (CTC) exam and characterize the type of polyps seen on OC but not reported by CTC. METHODS: Over an 18-month period a total of 159 asymptomatic adults had polyps seen...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics