Comparative Study of Conventional Colonoscopy and Pan-Colonic Narrow-Band Imaging System in the Detection of Neoplastic Colonic Polyps: A Randomized, Controlled Trial

Inoue, Takuya; Murano, Mitsuyuki; Murano, Naoko; Kuramoto, Takanori; Kawakami, Ken; Abe, Yosuke; Morita, Eijiro; Toshina, Ken; Egashira, Yasuyuki; Umegaki, Eiji; Higuchi, Kazuhide

doi:10.1016/j.gie.2008.03.886

Cited by 35 publications

(51 citation statements)

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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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“…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%

“…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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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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“…The ability of NBI endoscopy to improve the detection of polyps has been evaluated in different studies, and contradictory results have been obtained. Some authors have reported an increase in adenoma detection rate, as well as in diminutive adenoma detection rate by performing NBI colonoscopy, rather than conventional colonoscopy [9].…”

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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Comparative Study of Conventional Colonoscopy and Pan-Colonic Narrow-Band Imaging System in the Detection of Neoplastic Colonic Polyps: A Randomized, Controlled Trial

Cited by 35 publications

References 0 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

The water method combined with chromoendoscopy enhances adenoma detection

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

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