Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial

Horimatsu, Takahiro; Sano, Yasushi; Tanaka, Shinji; Kawamura, Takuji; Saito, Shôichi; Iwatate, Mineo; Oka, Shiro; Uno, Koji; Yoshimura, Kenichi; Ishikawa, Hideki; Muto, Manabu; Tajiri, Hisao

doi:10.1007/s00384-015-2230-x

Cited by 58 publications

(59 citation statements)

References 29 publications

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“…The evaluation was performed by four endoscopists who had not viewed any of these videos before this study. Of the four endoscopists, two were classified as non-experts (had performed < 5000 colonoscopies and 10 – 30 withdrawing colonoscopies with BLI-bright and LCI) and two were classified as experts (had performed ≥ 5000 colonoscopies and 300 withdrawing colonoscopies with BLI-bright and LCI) according to a previous report 9 . All of the videos were viewed in a randomized order.…”

Section: Methodsmentioning

confidence: 99%

“…However, the polyp miss rate under white light (WL) observation was reported to be 20 – 25 % 5 . Therefore, narrow-band imaging (NBI; Olympus Medical Co., Tokyo, Japan), flexible spectral imaging color enhancement (FICE; Fujifilm Co., Tokyo, Japan), and chromoendoscopy were investigated to determine whether they could improve the polyp detection rate; however, most of them failed 6 7 8 9 10 11 . …”

Section: Introductionmentioning

confidence: 99%

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Linked color imaging improves the visibility of colorectal polyps: a video study

et al. 2017

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Background/study aim Linked color imaging (LCI) by a laser endoscope (Fujifilm Co, Tokyo, Japan) is a novel narrow band light observation. In this study, we aimed to investigate whether LCI could improve the visibility of colorectal polyps using endoscopic videos. Patients and methods We prospectively recorded videos of consecutive polyps 2 – 20 mm in size diagnosed as neoplastic polyps. Three videos, white light (WL), blue laser imaging (BLI)-bright, and LCI, were recorded for each polyp by one expert. After excluding inappropriate videos, all videos were evaluated in random order by two experts and two non-experts according to a published polyp visibility score from four (excellent visibility) to one (poor visibility). Additionally, the relationship between polyp visibility scores in LCI and various clinical characteristics including location, size, histology, morphology, and preparation were analyzed compared to WL and BLI-bright. Results We analyzed 101 colorectal polyps (94 neoplastic) in 66 patients (303 videos). The mean polyp size was 9.0 ± 8.1 mm and 54 polyps were non-polypoid. The mean polyp visibility scores for LCI (2.86 ± 1.08) were significantly higher than for WL and BLI-bright (2.53 ± 1.15, P < 0.001; 2.73 ± 1.47, P < 0.041). The ratio of poor visibility (score 1 and 2) was significantly lower in LCI for experts and non-experts (35.6 %, 33.6 %) compared with WL (49.6 %, P = 0.015, 50.5 %, P = 0.046). The polyp visibility scores for LCI were significantly higher than those for WL for all of the factors. With respect to the comparison between BLI-bright and WL, the polyp visibility scores for BLI-bright were not higher than WL for right-sided location, < 10 mm size, sessile serrated adenoma and polyp histology, and poor preparation. For those characteristics, LCI improved the lesions with right-sided location, SSA/P histology, and poor preparation significantly better than BLI. Conclusions LCI improved polyp visibility compared to WL for both expert and non-expert endoscopists. It is useful for improving polyp visibility in any location, any size, any morphology, any histology, and any preparation level.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Linked color imaging improves the visibility of colorectal polyps: a video study

et al. 2017

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“…Previously, we clarified that the new generation of NBI by the LUCERA ELITE system improved better polyp visibility score than WLI [17]. A multicenter study showed that new generation NBI (LUCERA ELITE system) improved polyp detection rate [7]. Additionally, we clarified that BLI-bright in laser endoscopic system yielded a better polyp visibility score than WLI [9].…”

Section: Discussionmentioning

confidence: 99%

High Enhancement Settings for White Light Observation Improves Colorectal Polyp Visibility in Color Difference Value and an Endoscopist’s Visibility

et al. 2018

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Background/Aims: Settings of structure and color enhancement (CE) change view of white light imaging and a preset low enhancement setting is used regularly. The aim of this study was to investigate whether higher enhancement settings increased colorectal lesions’ visibility with endoscopists’ visibility scoring and objective color difference (CD) value. Methods: From April 2015 to September 2015, we analyzed 27 pictures and 100 videos of colorectal lesions. Combinations of structure enhancement (B3, A3, A5) and CE (CE 0, 1, 3) were evaluated and CD values of 2 corresponding modes (high enhancement: A5 + CE3, preset low enhancement: A3 + CE0) were calculated using marketed software. In the video, these 2 modes were evaluated. All pictures and movies were graded by 4 endoscopists using visibility scores: score 4 (excellent) to score 1 (poor). Results: The scores of A3 + CE0 (2.74 ± 1.09) were significantly lower than those of all other higher enhancement settings such as B3 + CE1 (3.11 ± 1.08), A3 + CE1 (3.33 ± 0.91), and A5 + CE3 (3.56 ± 0.74; p < 0.001). The CD value of A5 + CE3 was significantly higher than A3 + CE0 (20.2 ± 6.9 vs. 12.9 ± 5.6, p < 0.001). In the video, the scores for A5 + CE3 were significantly higher than A3 + CE0 (3.27 ± 0.83 vs. 2.53 ± 1.05, p < 0.001). Conclusions: Higher enhancement settings increased visibility of colorectal lesions.

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“…The possible reasons for missing these lesions include poor visualization of the back of the folds and inner curve of the flexures [5], as well as insufficient physician endoscopic technique [6, 7]. Several reports of high-definition, wide-angle colonoscopy have provided significantly improved polyp detection rates compared with those achieved with SC [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

Preliminary Experience Using Full-Spectrum Endoscopy for Colorectal Cancer Screening: Matched Case Controlled Study

Ito

Imai

Yoshida

et al. 2016

Gastroenterology Research and Practice

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Background/Aim. High-quality colonoscopy is needed to reduce the morbidity and mortality of colorectal cancer. Full-spectrum endoscopy (FUSE) has recently shown potential in improving adenoma detection during colonoscopy. This study aimed to evaluate the feasibility and utility of FUSE colonoscopy. Methods. From April 2015 to February 2016, 130 patients underwent FUSE colonoscopy for screening at a tertiary cancer center. Cecal intubation rate (CIR), procedure time, polyp/adenoma detection rate (PDR/ADR), and mean number of adenomas per colonoscopy (APC) were compared in matched-control patients (n = 260) who underwent standard colonoscopy (SC). Accordingly, endoscopists subjectively evaluated the utility of FUSE colonoscopy. Results. The CIR of FUSE colonoscopy was 94.6%. Cecal intubation time (8.8 min versus 5.1 min, P < 0.001) and total procedure time (21.6 min versus 17.3 min, P < 0.001) in the FUSE group were significantly longer than those in the SC group. PDR (68.3 versus 71.2%, P = 0.567), ADR (63.4% versus 58.5%, P = 0.355), and APC (1.4 versus 1.4, P = 0.917) were not significantly different between the two groups. The wide view of FUSE colonoscopy was superior to that of SC based on the questionnaires. Conclusions. FUSE colonoscopy did not demonstrate superiority to SC in a clinical setting.

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Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial

Abstract: Although WA colonoscopy did not improve the polyp detection, next-generation NBI colonoscopy represents a significant improvement in the detection of colonic polyps.

Cited by 58 publications

References 29 publications

Linked color imaging improves the visibility of colorectal polyps: a video study

Linked color imaging improves the visibility of colorectal polyps: a video study

High Enhancement Settings for White Light Observation Improves Colorectal Polyp Visibility in Color Difference Value and an Endoscopist’s Visibility

Preliminary Experience Using Full-Spectrum Endoscopy for Colorectal Cancer Screening: Matched Case Controlled Study

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