title: A comparison of conventional endoscopy, chromoendoscopy, and the optimal-band imaging system for the differentiation of neoplastic and non-neoplastic colonic polyps.
abstract: BACKGROUND
  The diagnostic accuracy of conventional endoscopy for small colonic polyps is not satisfactory. Optimal band imaging (OBI) enhances the contrast of the mucosal surface without the use of dye.
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy for the differentiation of neoplastic and non-neoplastic colorectal polyps by using magnified OBI colonoscopy.
  
  
  METHODS
  An open prospective study.
  
  
  METHODS
  Jichi Medical University, Japan.
  
  
  METHODS
  A total of 133 colonoscopy cases.
  
  
  METHODS
  A comparative study of the overall accuracy, sensitivity, and specificity for the differentiation of neoplastic and non-neoplastic colorectal polyps < or =5 mm in size by capillary-pattern diagnosis by using conventional colonoscopy, capillary-pattern diagnosis in OBI, and pit-pattern diagnosis in chromoendoscopy with low magnification.
  
  
  RESULTS
  A total of 107 polyps, composed of 80 neoplastic and 27 non-neoplastic polyps, were evaluated. OBI clearly showed the capillary network of the surface mucosa of neoplastic polyps at low magnification, whereas the surface mucosa of non-neoplastic polyps showed up as a pale lesion. The capillary pattern in conventional colonoscopy had 74% accuracy, 71% sensitivity, and 81% specificity for neoplastic polyps. The accuracy and sensitivity were significantly lower than those that used the capillary pattern in OBI (accuracy 87% and sensitivity 93%) and the pit pattern in chromoendoscopy (accuracy 86% and sensitivity 90%). There were no significant differences in specificity (OBI 70% and chromoendoscopy 74%). The kappa analysis indicated good agreement in both OBI and chromoendoscopy.
  
  
  CONCLUSIONS
  Capillary-pattern diagnosis in OBI is superior to that in conventional endoscopy and is not significantly different from pit-pattern diagnosis for predicting the histology of small colorectal polyps.
authors.affiliation: Division of Endoscopy, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan. ktogashi@jichi.ac.jp
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Togashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Osawa
authors.forename: Koji
authors.initials: K
authors.lastname: Koinuma
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Miyata
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sunada
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nokubi
authors.forename: Hisanaga
authors.initials: H
authors.lastname: Horie
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D004396:Coloring Agents