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Adenoma detection improves with narrow band imaging; miss rate unchanged
A new generation of narrow band imaging proved more effective than conventional high-definition white light colonoscopy in detecting colorectal adenomas or polyps, but did not improve miss rates, according to new research.
In a randomized tandem colonoscopy study of 360 patients, investigators found that 190-narrow band imaging (190-NBI; twofold brighter than the previous version) improved detection rates among all endoscopists, regardless of experience, when compared to conventional high-definition white light colonoscopy (HD-WL).
Patients in the controlled trial received either 190-NBI or HD-WL colonoscopy, with adenoma detection and miss rates based on lesions detected on first-pass and second-pass examination, respectively.
Adenoma and polyp detection rates were higher in the 190-NBI groups compared with the HD-WL group (48.3% vs. 34.4%, P=.01; polyps: 61.1% vs. 48.3%, P=.02).
On average, polyp detection per patient was higher in the 190-NBI group (1.49% vs. 1.13, P=.07). Investigators found no difference in the adenoma miss rates between the groups (21.8% vs. 21.2%).
Using multivariate analysis, researchers concluded that use of 190-NBI (OR=1.85; 95% CI, 1.10-3.12), withdrawal time (OR=1.29; 95% CI, 1.19-1.38), patient age (OR=1.04; 95% CI, 1.01-1.06), and male gender (OR=2.38; 95% CI, 1.42-3.99) were associated with adenoma detection.
But because the 190-NBI system did not appear to reduce the adenoma miss rate, researchers concluded that “other approaches to increase mucosal coverage rather than image enhancement may be needed to reduce the adenoma miss rate.”
Disclosure: Study authors reported no relevant financial disclosures.