title: Narrow-band imaging for the detection of polyps in patients with serrated polyposis syndrome: a multicenter, randomized, back-to-back trial.
abstract: BACKGROUND
  Serrated polyposis syndrome (SPS) is characterized by the presence of multiple serrated polyps spread throughout the colon. Patients with SPS are considered to be at risk of colorectal cancer and are advised to undergo endoscopic surveillance. Narrow-band imaging (NBI) may improve the detection of polyps during these surveillance colonoscopies.
  
  
  OBJECTIVE
  To compare polyp miss rates between NBI and high-resolution white-light endoscopy (HR-WLE).
  
  
  METHODS
  Multicenter, randomized, crossover study.
  
  
  METHODS
  Four tertiary referral institutions.
  
  
  METHODS
  A total of 52 patients with SPS undergoing surveillance colonoscopy.
  
  
  METHODS
  All patients underwent back-to-back colonoscopies with HR-WLE and NBI in a randomized order.
  
  
  METHODS
  Polyp miss rates of HR-WLE and NBI.
  
  
  RESULTS
  In the HR-WLE group, 116 polyps were detected during the first inspection. A second inspection with NBI added 47 polyps, resulting in an overall polyp miss rate of 29% with HR-WLE (95% confidence interval, 22-36). In the NBI group, a total of 128 polyps were detected during the first inspection. Subsequent inspection with HR-WLE added 32 polyps, resulting in an overall polyp miss rate of NBI of 20% (95% confidence interval, 15-27). Comparison of the overall polyp miss rates of HR-WLE and NBI showed no significant difference (P = .065).
  
  
  CONCLUSIONS
  Small sample size; second inspection was performed by the same endoscopist.
  
  
  CONCLUSIONS
  The results of our study suggest that NBI does not reduce polyp miss rates in patients with SPS compared with HR-WLE. Further multinational studies with larger numbers of patients are warranted to verify these results. (
  
  
  BACKGROUND
  NTR2497.).
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Yark
authors.initials: Y
authors.lastname: Hazewinkel
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Kristien M A J
authors.initials: KM
authors.lastname: Tytgat
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands and Department of Gastroenterology and Hepatology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Monique E
authors.initials: ME
authors.lastname: van Leerdam
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Jan-Jacob
authors.initials: JJ
authors.lastname: Koornstra
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bastiaansen
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Susanne
authors.initials: S
authors.lastname: van Eeden
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging