title: Detection of colorectal adenoma by narrow band imaging (HQ190) vs. high-definition white light colonoscopy: a randomized controlled trial.
abstract: OBJECTIVE
  The benefits of narrow band imaging (NBI) on enhancing colorectal adenoma detection remain questionable. We tested whether the new generation of NBI (190-NBI), which is twice as bright as the previous version, would improve adenoma detection when compared with high-definition white light (HD-WL) colonoscopy.
  
  
  METHODS
  It was a randomized controlled trial with tandem colonoscopy. We recruited patients who underwent colonoscopy for symptoms, screening, or surveillance. Patients were randomized for the use of either 190-NBI or HD-WL on withdrawal. Tandem colonoscopy was performed by using the same assigned colonoscope and withdrawal method. Lesions detected on first-pass and second-pass examination were used for adenoma detection and miss rates, respectively. The primary outcomes were adenoma and polyp detection rates.
  
  
  RESULTS
  A total of 360 patients were randomized to undergo either 190-NBI or HD-WL colonoscopy. Both the adenoma and polyp detection rates were significantly higher in the 190-NBI group compared with the HD-WL group (adenoma: 48.3% vs. 34.4%, P=0.01; polyps: 61.1% vs. 48.3%, P=0.02). The mean number of polyps detected per patient was higher in the 190-NBI group (1.49% vs. 1.13, P=0.07). There was no significant difference in the adenoma miss rates between the two groups (21.8% vs. 21.2%). Multivariate analysis showed that the use of 190-NBI (odds ratio (OR) 1.85; 95% confidence interval (CI) 1.10-3.12), withdrawal time (OR 1.29; CI 1.19-1.38), patient's age (OR 1.04; CI 1.01-1.06), and male gender (OR 2.38; CI 1.42-3.99) were associated with adenoma detection.
  
  
  CONCLUSIONS
  190-NBI colonoscopy was superior to the conventional HD-WL in detecting colorectal adenomas or polyps, but there was no significant difference in adenoma miss rates.
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Wai K
authors.initials: WK
authors.lastname: Leung
authors.affiliation: Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Oswens S H
authors.initials: OS
authors.lastname: Lo
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Kevin S H
authors.initials: KS
authors.lastname: Liu
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Teresa
authors.initials: T
authors.lastname: Tong
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: David Y K
authors.initials: DY
authors.lastname: But
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Frank Y F
authors.initials: FY
authors.lastname: Lam
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Axel S J
authors.initials: AS
authors.lastname: Hsu
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: S Y
authors.initials: SY
authors.lastname: Wong
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: W K Walter
authors.initials: WK
authors.lastname: Seto
authors.affiliation: Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Ivan F N
authors.initials: IF
authors.lastname: Hung
authors.affiliation: Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: W L
authors.initials: WL
authors.lastname: Law
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D011446:Prospective Studies