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• W4253679237 abstract "Background: There is no widely-adopted, easily applied method for distinguishing between adenomatous and non-adenomatous polyps during real-time colonoscopy. This results in the needless removal of many non-adenomatous polyps which increases costs and risk to the patient. Aims: To compare standard broad-band white light (WL) with narrow band imaging (NBI) for the differentiation of colorectal polyps during in vivo, real-time colonoscopy and to assess whether a learning curve exists for NBI. Methods: 302 patients undergoing routine colonoscopy by four experienced colonoscopists were recruited prospectively between August, 2006 and July, 2007 . Standard WL colonoscopy was performed with Olympus 180 series high-definition colonoscopes. When each polyp was found, it was first examined by WL (1.5x; total magnification up to 70x) and diagnosed endoscopically as adenomatous or non-adenomatous, and then reexamined at the same magnification with NBI. Modified Kudo pit pattern and vascular color intensity (VCI) were recorded, and histology was predicted. Each polyp was then removed and sent for histologic evaluation. Endoscopists were given feedback every 2 weeks regarding the accuracy of their predictions. Results: 268 polyps were found in 132 patients; 50% were non-adenomatous (hyperplastic, abberant crypt foci, lymphoglandular complex, sessile serrated polyp, serrated polyp NOS, other). Diagnostic accuracy was 81% with NBI and 78% for WL (p = 0.35). Accuracies were significantly better for larger polyps and those with polypoid shape but there was no difference between NBI and WL. NBI performed better than WL in diagnosing adenomas (sensitivity 81% vs. 69%, p < 0.05), particularly those < 5mm (75% vs. 60%, p < 0.05). The accuracy was lowest for sessile serrated polyps (47% vs. 86% for all other non-adenomatous polyps, p < 0.001). Non-adenomatous polyps were more likely to have a “light” VCI compared with adenomas (71% vs. 29%, p < 0.001). During the second half of the study, NBI accuracy for differentiating polyps improved from 74% to 87% and outperformed an unchanged WL accuracy of 79% (p < 0.05). The improvement was most pronounced for adenomas (72% to 89%, p < 0.05). Additionally, when endoscopists changed their diagnosis after NBI examination, they were correct 56% of the time in the first half of the study compared with 80% in the second half. Conclusions: There is a learning curve associated with NBI when using it to differentiate colorectal polyps in vivo. With experience, NBI becomes more accurate than WL. Further refinements of an NBI pit pattern classification and vascular color intensity scale are needed." @default.
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• W4253679237 date "2008-04-01" @default.
• W4253679237 modified "2023-10-14" @default.
• W4253679237 title "Narrow Band Imaging Without High Magnification to Differentiate Polyps During Real-Time Colonoscopy: Improvement with Experience" @default.
• W4253679237 doi "https://doi.org/10.1016/j.gie.2008.03.117" @default.
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