Multicenter Randomised Controlled Trial Comparing the High Definition White Light Endoscopy and the Bright Narrow Band Imaging for Colon Polyps

Overview

Journal World J Gastrointest Endosc

Publisher Baishideng Publishing Group

Date 2017 Jul 11

PMID 28690771

Citations 5

Authors

Rajvinder Singh

Kuan Loong Cheong

Leonardo Zorron Cheng Tao Pu

Dileep Mangira

Doreen Siew Ching Koay

Carmen Kee

Siew Chien Ng

Rungsun Rerknimitr

Satimai Aniwan

Tiing-Leong Ang

Khean-Lee Goh

Shiaw Hooi Ho

James Yun-Wong Lau

Affiliations

Soon will be listed here.

Abstract

Aim: To compare high definition white light endoscopy and bright narrow band imaging for colon polyps' detection rates.

Methods: Patients were randomised to high definition white light endoscopy (HD-WLE) or the bright narrow band imaging (bNBI) during withdrawal of the colonoscope. Polyps identified in either mode were characterised using bNBI with dual focus (bNBI-DF) according to the Sano's classification. The primary outcome was to compare adenoma detection rates (ADRs) between the two arms. The secondary outcome was to assess the negative predictive value (NPV) in differentiating adenomas from hyperplastic polyps for diminutive rectosigmoid lesions.

Results: A total of 1006 patients were randomised to HD-WLE ( = 511) or bNBI ( = 495). The mean of adenoma per patient was 1.62 and 1.84, respectively. The ADRs in bNBI and HD-WLE group were 37.4% and 39.3%, respectively. When adjusted for withdrawal time (OR = 1.19, 95%CI: 1.15-1.24, < 0.001), the use of bNBI was associated with a reduced ADR (OR = 0.69, 95%CI: 0.52-0.92). Nine hundred and thirty three polyps (86%) in both arms were predicted with high confidence. The sensitivity (Sn), specificity (Sp), positive predictive value and NPV in differentiating adenomatous from non-adenomatous polyps of all sizes were 95.9%, 87.2%, 94.0% and 91.1% respectively. The NPV in differentiating an adenoma from hyperplastic polyp using bNBI-DF for diminutive rectal polyps was 91.0%.

Conclusion: ADRs did not differ between bNBI and HD-WLE, however HD-WLE had higher ADR after adjustment of withdrawal time. bNBI surpassed the PIVI threshold for diminutive polyps.

Citing Articles

Narrow Band Imaging versus White Light for the Detection of Sessile Serrated Colorectal Lesions: A Randomized Clinical Trial.

Ferreira A, Reves J, Nascimento C, Frias-Gomes C, Costa-Santos M, Roque Ramos L GE Port J Gastroenterol. 2023; 30(5):368-374.

PMID: 37868631 PMC: 10586213. DOI: 10.1159/000526606.

Mucosal imaging in colon polyps: New advances and what the future may hold.

Young E, Rajandran A, Philpott H, Sathananthan D, Hoile S, Singh R World J Gastroenterol. 2023; 28(47):6632-6661.

PMID: 36620337 PMC: 9813932. DOI: 10.3748/wjg.v28.i47.6632.

Narrow band imaging versus white light for detecting sessile serrated lesion: A prospective randomized multicenter study.

Staudenmann D, Liu K, Varma P, Wong M, Rai S, Tsoutsman T DEN Open. 2022; 2(1):e44.

PMID: 35310703 PMC: 8828189. DOI: 10.1002/deo2.44.

Gastrointestinal diagnosis using non-white light imaging capsule endoscopy.

Cummins G, Cox B, Ciuti G, Anbarasan T, Desmulliez M, Cochran S Nat Rev Gastroenterol Hepatol. 2019; 16(7):429-447.

PMID: 30988520 DOI: 10.1038/s41575-019-0140-z.

Linked color imaging enhances endoscopic detection of sessile serrated adenoma/polyps.

Fujimoto D, Muguruma N, Okamoto K, Fujino Y, Kagemoto K, Okada Y Endosc Int Open. 2018; 6(3):E322-E334.

PMID: 29527554 PMC: 5842067. DOI: 10.1055/s-0043-124469.

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