Detectability of colorectal neoplastic lesions using a narrow-band imaging system: a pilot study.
OBJECTIVE
Flat and depressed colorectal neoplastic lesions can be difficult to identify using conventional colonoscopy techniques. Narrow-band imaging (NBI) provides unique views especially of mucosal vascular network and helps in visualization of neoplasia by improving contrast. The aim of this study was to assess the feasibility of using NBI for colorectal neoplasia screening.


METHODS
Forty-seven consecutive patients, who underwent high definition colonoscopy (HDC) screening examinations revealing neoplastic lesions, were enrolled in our prospective study. No biopsies or resections were performed during the initial HDC, but patients in whom lesions were detected underwent further colonoscopies using NBI, with the results of the first examination blinded from the colonoscopist. They then received appropriate treatment. We compared diagnostic detection rates of neoplastic lesions for HDC and NBI procedures using total number of all identified neoplastic lesions as reference standard.


RESULTS
Altogether, 153 lesions were detected and analyzed in 43 patients. Mean diagnostic extubation times were not significantly different (P = 0.18), but the total number of lesions detected by NBI was higher (134 vs 116; P = 0.02). Based on macroscopic type, flat lesions were identified more often by NBI (P = 0.04). As for lesion size, only flat lesions < 5 mm were detected more frequently (P = 0.046). Lesions in the right colon were identified more often by NBI (P = 0.02), but NBI missed two flat lesions >or= 10 mm located there.


CONCLUSIONS
Narrow band imaging colonoscopy may represent a significant improvement in the detection of flat and diminutive lesions, but a future multi-center controlled trial should be conducted to fully evaluate efficacy for screening colonoscopies.
Uraoka
Toshio
T
Division of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.
Saito
Yutaka
Y
Matsuda
Takahisa
T
Sano
Yasushi
Y
Ikehara
Hisatomo
H
Mashimo
Yumi
Y
Kikuchi
Tsuyoshi
T
Saito
Daizo
D
Saito
Hiroshi
H
D003106:Colon / Q000473:pathology*; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005240:Feasibility Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007413:Intestinal Mucosa / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014741:Video Recording