Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial.
OBJECTIVE
Previous studies have yielded conflicting results on the colonic polyp detection rate with narrow-band imaging (NBI) compared with white-light imaging (WLI). We compared the mean number of colonic polyps detected per patient for NBI versus WLI using a next-generation NBI system (EVIS LUCERA ELITE; Olympus Medical Systems) used with standard-definition (SD) colonoscopy and wide-angle (WA) colonoscopy.


METHODS



METHODS
this study is a 2 × 2 factorial, prospective, multicenter randomized controlled trial.


METHODS
this study was conducted at five academic centers in Japan.


METHODS
patients were allocated to one of four groups: (1) WLI with SD colonoscopy (H260AZI), (2) NBI with SD colonoscopy (H260AZI), (3) WLI with WA colonoscopy (CF-HQ290), and (4) NBI with WA colonoscopy (CF-HQ290).


RESULTS
the mean numbers of polyps detected per patient were compared between the four groups: WLI with/without WA colonoscopy and NBI with/without WA colonoscopy.


RESULTS
Of the 454 patients recruited, 431 patients were enrolled. The total numbers of polyps detected by WLI with SD, NBI with SD, WLI with WA, and NBI with WA were 164, 176, 188, and 241, respectively. The mean number of polyps detected per patient was significantly higher in the NBI group than in the WLI group (2.01 vs 1.56; P = 0.032). The rate was not higher in the WA group than in the SD group (1.97 vs 1.61; P = 0.089).


CONCLUSIONS
Although WA colonoscopy did not improve the polyp detection, next-generation NBI colonoscopy represents a significant improvement in the detection of colonic polyps.
Department of Therapeutic Oncology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin Sakyo, Kyoto, 606-8507, Japan, thorimat@kuhp.kyoto-u.ac.jp.
Takahiro
T
Horimatsu
Yasushi
Y
Sano
Shinji
S
Tanaka
Takuji
T
Kawamura
Shoichi
S
Saito
Mineo
M
Iwatate
Shiro
S
Oka
Koji
K
Uno
Kenichi
K
Yoshimura
Hideki
H
Ishikawa
Manabu
M
Muto
Hisao
H
Tajiri
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging / Q000379:methods*; D011446:Prospective Studies