The Impact of Narrow Band Imaging in Screening Colonoscopy: A Randomized Controlled Trial

Paggi, Silvia; Radaelli, Franco; Amato, Arnaldo; Meucci, G.; Mandelli, Giovanni; Imperiali, G.; Spinzi, Giancarlo; Terreni, N.; Lenoci, Nicoletta; Terruzzi, Vittorio

doi:10.1016/j.cgh.2009.06.028

Cited by 91 publications

(53 citation statements)

References 32 publications

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“…The ADR of 62% using the water with indigo carmine method was higher than those derived from studies using other modalities, even those obtained with high definition colonoscopes 15,[21][22][23] , narrow band imaging (NBI) 24,27,28 or dye spray chromoendoscopy [35][36][37] . Conventional targeted dye-spray chromoendoscopy has been reported to require up to an average of 33 minutes in total procedure time 13 , 26 minutes in withdrawal time 10 , or a median withdrawal time of 25 minutes (range 8 -153 min) 37 .…”

Section: Discussionmentioning

confidence: 86%

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The water method combined with chromoendoscopy enhances adenoma detection

Leung¹,

Ransibrahmanakul²,

Toomsen³

et al. 2011

jig

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Background:The water method is easy-to-learn and improves colonoscopy outcomes. Dye-spray chromoendoscopy enhances ADR but has not been widely accepted for routine application in screening or surveillance colonoscopy. Hypothesis: With dye added to the water used in the water method, ADR can be enhanced compared with the water or air method alone. Objective: To compare ADR determined by the air method, water method alone, and water method with indigo carmine (0.008%) added. Design: Review of prospectively collected data in a performance improvement program. Setting: VA endoscopy unit. Patient: Screening or surveillance colonoscopy. Methods: Patients (n=50/group) underwent colonoscopy with each of the three methods. Water method involved warm water infusion in lieu of air insufflation coupled with removal of residual air by suction and residual feces by water exchange. ADR and procedural data were collected prospectively to monitor performance. Main Outcome Measurements: ADR. Results: ADR in the air method, water method alone and water method with indigo carmine were 36%, 40% and 62%, respectively. Water method with indigo carmine produced significantly higher ADR than the air or water method alone (p<0.05). Limitations: Non-randomized data, single VA site, retrospective comparison. Absence of significant difference between air and water methods could be a type II error due to small number of patients Conclusions: The approach with indigo carmine added to the water used in the water method yielded significantly higher ADR than the water or the air method alone. The data suggest that a prospective RCT to compare the different methods is warranted.

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Section: Discussionmentioning

confidence: 86%

“…Distal = distal to the splenic flexure. definition, wide-angle endoscope 15,[21][22][23][24][25] ; narrow band imaging [26][27][28] ; transparent hood attached to the tip of the colonoscope 26,29,30 withdrawal time >6 min 31,32 or modified (e.g. split-dose) bowel preparation 33,34 .…”

Section: Discussionmentioning

confidence: 99%

The water method combined with chromoendoscopy enhances adenoma detection

Leung¹,

Ransibrahmanakul²,

Toomsen³

et al. 2011

jig

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“…10 In addition, a controlled trial performed in fecal-occult-blood-test-positive Narrow-band imaging in the colonpatients did not show any difference in adenoma detection rates between the NBI and white-light endoscopy arms during instrument withdrawal. 11 Only one randomized controlled trial has so far demonstrated a significant increase in adenoma detected per patient in the NBI compared with the white-light endoscopy group, but when the proportion of patients with at least one adenoma was compared between the two modalities, no advantage could be demonstrated. 9 This study was limited by an uneven distribution of NBI allocation to participating endoscopists, as one endoscopist was allocated more NBI procedures and the differences may be attributable to this.…”

Section: Detection Of Lesionsmentioning

confidence: 99%

Narrow‐band imaging in the colon: Limitations and potentials

Lau

2011

J of Gastro and Hepatol

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Narrow-band imaging (NBI) is a new endoscopic technology that highlights surface structures and superficial mucosal capillaries during colonoscopy at a single push of a button. NBI has a high sensitivity and specificity for differentiating neoplastic and nonneoplastic polyps by means of mucosal and capillary patterns. It is also useful in determining the invasion depth of early colorectal cancers and evaluating free margins after endoscopic resection. However, it has not been shown to improve the adenoma detection rate compared with white-light endoscopy. Although narrow-band imaging is now available commercially, its role in routine clinical practice during colonoscopy is not well defined. The difficulties in interpreting results partly relate to different NBI nomenclatures used in classifying colonic adenomas and their lack of standardization. Future research should focus on establishing a reliable NBI nomenclature for capillary patterns, defining the learning curve and interobserver variation, and validating the effectiveness of NBI in routine colonoscopy.

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“…Even so, a lower miss rate for adenoma in the proximal colon was achieved by performing NBI colonoscopy [10], while the detection rate of flat adenomas has increased with NBI [11]. Recent meta-analyses and systematic reviews have also shown that NBI provides no increase in adenoma or polyp detection rates compared with conventional colonoscopy [12,13].…”

Section: Characterization Of Colonic Lesionsmentioning

confidence: 99%

The Usefulness Of Narrow Band Imaging Endoscopy For The Real Time Characterization Of Colonic Lesions

Boeriu

Pascarenco

Brusnic

et al. 2016

Acta Medica Marisiensis

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Narrow band imaging represents a promising endoscopic technique which allows real time characterization of colonic lesions by assessment of mucosal and vascular patterns. Due to the ability to make an optical biopsy, NBI could become a useful tool in clinical decisions regarding therapy and surveillance. The aim of this paper is to review the current knowledge on the optical diagnosis of colonic lesions by using NBI endoscopy. We reviewed research articles, reviews and meta-analyses from the PubMed and MEDLINE containing relevant data in this field. The validity of endoscopic criteria for the differentiation of adenoma and hyperplastic polyps, as well as of invasive cancer, has been evaluated in recent studies. Based on the prediction of polyp histology, new potential cost saving strategies have been proposed. Many reports are focused on the accuracy of optical biopsy by using NBI for predicting colonoscopy surveillance intervals and adenomatous histology in diminutive polyps, according to the Preservation and Incorporation of Valuable Endoscopic Innovations statement. Optical diagnosis is still under evaluation, and cannot yet be endorsed in routine practice. The high level of performance achieved by expert endoscopists needs to be replicated in the community utilizing reliable and standardized endoscopic criteria. IntroductionThe development of advanced endoscopic techniques such as narrow band imaging endoscopy, with or without magnification, represents an important step in the improvement of characterization of colonic lesions by predicting underlying histology. This creates the possibility to adopt new strategies regarding therapy and surveillance in clinical practice. The potential benefits of the real time estimation of a polyp's histology during NBI endoscopy, so called "optical biopsy", are related to potentially decreasing total costs of colonoscopy by eliminating unnecessary biopsies and polypectomies. Recent reports have shown promising results in this field, but controversies remain. Concerns center upon a lack of standardization among different classification systems, variable inter-observer agreement, and lagging clinical acceptance.The aim of this paper is to assess the current knowledge on the optical diagnosis of colonic lesions by using NBI endoscopy. We reviewed research articles, reviews and meta-analyses published in the last eight years in the PubMed and MEDLINE databases for the following search terms: narrow band imaging endoscopy, colonic polyps, and colorectal neoplasia.

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The Impact of Narrow Band Imaging in Screening Colonoscopy: A Randomized Controlled Trial

Cited by 91 publications

References 32 publications

The water method combined with chromoendoscopy enhances adenoma detection

The water method combined with chromoendoscopy enhances adenoma detection

Narrow‐band imaging in the colon: Limitations and potentials

The Usefulness Of Narrow Band Imaging Endoscopy For The Real Time Characterization Of Colonic Lesions

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