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The impact of narrow band imaging for colon polyp detection: a multicenter randomized controlled trial by tandem colonoscopy

Authors
  • Ikematsu, Hiroaki1
  • Saito, Yutaka2
  • Tanaka, Shinji3
  • Uraoka, Toshio4
  • Sano, Yasushi5
  • Horimatsu, Takahiro6
  • Matsuda, Takahisa2
  • Oka, Shiro3
  • Higashi, Reiji4
  • Ishikawa, Hideki7
  • Kaneko, Kazuhiro1
  • 1 National Cancer Center Hospital East, Department of Gastroenterology and Gastrointestinal Oncology, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan , Kashiwa (Japan)
  • 2 National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan , Tokyo (Japan)
  • 3 Hiroshima University, Department of Endoscopy, Hiroshima, Japan , Hiroshima (Japan)
  • 4 Okayama University Hospital, Department of Endoscopy, Okayama, Japan , Okayama (Japan)
  • 5 Sano Hospital, Gastrointestinal Center, Kobe, Japan , Kobe (Japan)
  • 6 Kyoto University, Department of Gastroenterology and Hepatology, Kyoto, Japan , Kyoto (Japan)
  • 7 Kyoto Prefectural University of Medicine, Department of Molecular-Targeting Cancer Prevention, Osaka, Japan , Osaka (Japan)
Type
Published Article
Journal
Journal of Gastroenterology
Publisher
Springer Japan
Publication Date
Mar 24, 2012
Volume
47
Issue
10
Pages
1099–1107
Identifiers
DOI: 10.1007/s00535-012-0575-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundPrevious studies have yielded conflicting results on the adenoma detection rate with narrow band imaging (NBI) compared with white light imaging (WLI). To overcome the confounding factors of these studies, we aimed to evaluate the colonic adenoma detection rate with primary NBI versus that with primary WLI by using consistent NBI system, endoscope, and imaging settings, and experienced colonoscopists.MethodsIn this multicenter prospective trial, 813 patients were randomized to undergo high-definition, tandem colonoscopy in the right colon with either NBI followed by WLI (NBI–WLI group) or WLI followed by NBI (WLI–NBI group). The NBI settings were fixed at surface structure enhancement level A-5 and adaptive index of hemoglobin color enhancement level 3. All detected polyps were resected or biopsied for histopathological analysis. The primary and secondary outcome measures were the adenoma detection rates and miss rates, respectively, with primary imaging.ResultsThe NBI–WLI and WLI–NBI groups comprised 389 and 393 patients, respectively, who met the inclusion criteria. The groups did not differ significantly in age, gender, institution, indication for colonoscopy, bowel preparation, or observation time. The adenoma detection rates of primary NBI and WLI were 42.3 and 42.5 %, respectively [difference not significant (NS)]. The adenoma miss rate was significantly less with primary NBI than with primary WLI (21.3 vs. 27.8 %; p = 0.03).ConclusionsNBI does not improve the adenoma detection rate during primary colonoscopy; however, it has a lower miss rate for adenoma lesions in the proximal colon than WLI.

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