A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect?

Adler, Andreas; Pohl, Heiko; Papanikolaou, Ioannis S.; Abou-Rebyeh, H.; Schachschal, Guido; Veltzke‐Schlieker, Wilfried; Khalifa, Ahmed C.; Setka, E.; Koch, Martin; Wiedenmann, Bertram; Rösch, Thomas

doi:10.1136/gut.2007.123539

Cited by 241 publications

(166 citation statements)

References 38 publications

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“…While still the gold standard for polyp detection, colonoscopic procedures have a definitive "miss rate" so that it can come close to, but does not appear able to reach perfection. Recent comparative and prospective studies using pan-colonic narrow-band imaging suggest that its use for surveillance of even small adenomas may be superior to conventional colonoscopy and equivalent to chromoendoscopy [15][16][17][18] . More widespread application of these evolving technologies in the future may also impact on the detection of serrated adenomas and current screening and surveillance guidelines.…”

Section: Future Screening For Colon Polypsmentioning

confidence: 99%

Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

Freeman¹

2008

WJG

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Current algorithms for screening and surveillance for colon cancer are valuable, but may be limited by the underlying nature of the targeted neoplastic lesions. Although part of the success of adenoma removal relates to interruption of so-called "adenoma-carcinoma sequence", an alternate serrated pathway to colon cancer may pose difficulties with the ultimate results achieved by traditional colonoscopic methods. The endpoint carcinoma in this unique pathway may be derived from a dysplastic serrated adenoma. These tend to be located primarily in the right colon, especially in females, and are frequently associated with coexistent colon cancer. Unfortunately, however, there are few, if any, other identifiable risk factors, including age or family history of colon polyps or colon cancer. Moreover, this alternate serrated pathway may itself also be quite biologically heterogeneous as reflected in sessile serrated adenomas (SSA) with virtually exclusive molecular signatures defined by the presence of either BRAF or KRAS mutations. Screening algorithms in the future may need to be modified and individualized, depending on new information that likely will emerge on the natural history of these biologically heterogeneous lesions that differs from traditional adenomatous polyps. Freeman HJ. Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance.

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Section: Future Screening For Colon Polypsmentioning

confidence: 99%

Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

Freeman¹

2008

WJG

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“…NBI is expected to result in better detection of colorectal adenomas and better distinction between neoplasms and nonneoplastic lesions. Recently, although several investigators in western countries have been trying to demonstrate its ability to detect colorectal adenomas, most randomized trials have reported negative results (Adler et al, 2008(Adler et al, , 2009). On the other hands, Japanese investigators have reported positive results in their articles (Inoue et al, 2008;Uraoka et al, 2008).…”

Section: Optical Methods For Minimizing the Overlooking Of Colorectalmentioning

confidence: 99%

Recent Advances in Diagnostic Endoscopy for Colorectal Neoplasm

Takeuchi¹,

Hanaoka²,

Hanafusa³

2011

Gastrointestinal Endoscopy

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“…Therefore, the cases in which NBI can display its full capability may be scarce. Furthermore, no statistically signi cant difference may exist between the ability to detect a colonic polyp by NBI compared to conventional endoscopy 31 . For these reasons, the merit of using NBI remains controversial.…”

Section: Evaluation Of Publication Biasmentioning

confidence: 99%

A Comparison of Magnifying Chromoendoscopy Versus Narrow Band Imaging in the Diagnosis of Depth of Invasion for Early Colorectal Cancers

Kobayashi

Kudo

Miyachi

et al. 2011

Showa Univ J Med Sci

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: Although chromoendoscopy and narrow band imaging NBI are widely used in diagnosing the invasion depth of colorectal cancers, comparative studies of these modalities are lacking. This meta-analysis compared the performance of these two modalities in colorectal cancer diagnosis. MEDLINE, EMBASE, and Cochrane Library were searched for relevant original articles published up to December 20 th , 2010. Major criteria for article inclusion were : i magnifying chromoendoscopy or NBI was used as a diagnostic modality and pit pattern or vascular pattern was used as a diagnostic classi cation ; ii sensitivity and speci city were reported ; iii absolute numbers of true-positive, false-positive, true-negative, and false-negative cases, or their equivalent, were provided ; and iv pathology of biopsy, endoscopy, or surgical treatment was used as the reference standard. Sensitivity and speci city were pooled using a random effects model. Regression analysis was performed to compare the discriminatory power between chromoendoscopy and NBI by including a dummy variable. We made the assumption that a positive regression coef cient implied a better discriminatory power for NBI, and vice versa. Of 1846 screened articles, 16 ful lled all inclusion criteria. Pooled sensitivity for chromoendoscopy and NBI was 0.85 95 CI : 0.82-0.87 and 0.80 0.76-0.85 , respectively, and specificity was 0.98 0.97-0.99 and 0.98 0.97-0.99 , respectively. The regression coef cient for chromoendoscopy versus NBI was 0.02 95 CI : 1.18-1.71 . These results indicate that chromoendoscopy and NBI may have similar power for the diagnostic assessment of colonic neoplasms. However, other factors such as convenience, time, and cost still must be taken into account in making the nal diagnostic choice.

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A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect?

Abstract: The increased adenoma detection rate means of NBI colonoscopy were statistically not significant. It remains speculative as to whether the increasing adenoma rate in the conventional group may have been caused by a training effect of better polyp recognition on NBI.

Cited by 241 publications

References 38 publications

Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

Recent Advances in Diagnostic Endoscopy for Colorectal Neoplasm

A Comparison of Magnifying Chromoendoscopy Versus Narrow Band Imaging in the Diagnosis of Depth of Invasion for Early Colorectal Cancers

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