title: Narrow-band imaging as an alternative to chromoendoscopy for the detection of dysplasia in long-standing inflammatory bowel disease: a prospective, randomized, crossover study.
abstract: BACKGROUND
  Narrow-band imaging (NBI) is a novel technique that may represent an alternative method to chromoendoscopy (CE) for the detection of colitis-associated intraepithelial neoplasia (IN) in patients with long-standing inflammatory bowel disease (IBD).
  
  
  OBJECTIVE
  To compare NBI with CE for the detection of IN.
  
  
  METHODS
  Prospective, randomized, crossover study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Patients with clinically inactive colonic IBD (≥8 years).
  
  
  METHODS
  Patients underwent both CE and NBI in randomized order. Targeted biopsy specimens from abnormal areas were obtained. Pathological examination was regarded as the reference standard.
  
  
  METHODS
  Number of false-positive and true-positive lesions in patients undergoing CE and NBI were compared as well as the proportion of patients with missed IN lesions.
  
  
  RESULTS
  Eighty patients were screened, of whom 20 were excluded. Mean ± standard deviation withdrawal time for CE was significantly longer than that for NBI (26.87 ± 9.89 minutes vs 15.74 ± 5.62 minutes, P < .01). Thirteen patients had at least 1 IN lesion on 1 of the examinations. In the per-lesion analysis, NBI resulted in a significantly inferior false-positive biopsy rate (P = .001) and a similar true-positive rate. The percentage of missed IN lesions and patients was superior with NBI, albeit without reaching statistical significance.
  
  
  CONCLUSIONS
  Lesions were sampled immediately after detection, which precluded the possibility of paired analysis.
  
  
  CONCLUSIONS
  NBI appears to be a less time-consuming and equally effective alternative to CE for the detection of IN. However, given the NBI lesion and patient miss rates, it cannot be recommended as the standard technique.
authors.affiliation: Endoscopic Unit, Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain. mpellise@clinic.ub.es
authors.forename: Maria
authors.initials: M
authors.lastname: Pellisé
authors.forename: Maria
authors.initials: M
authors.lastname: López-Cerón
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodríguez de Miguel
authors.forename: Mireya
authors.initials: M
authors.lastname: Jimeno
authors.forename: Michel
authors.initials: M
authors.lastname: Zabalza
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
authors.forename: Montserrat
authors.initials: M
authors.lastname: Aceituno
authors.forename: Glòria
authors.initials: G
authors.lastname: Fernández-Esparrach
authors.forename: Angels
authors.initials: A
authors.lastname: Ginès
authors.forename: Oriol
authors.initials: O
authors.lastname: Sendino
authors.forename: Miriam
authors.initials: M
authors.lastname: Cuatrecasas
authors.forename: Josep
authors.initials: J
authors.lastname: Llach
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
mesh_terms: D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007203:Indigo Carmine; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity
chemical_list: D004396:Coloring Agents; D007203:Indigo Carmine