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The impact of narrow band imaging for colon polyp detection: a multicenter randomized controlled trial by tandem colonoscopy

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Abstract

Background

Previous studies have yielded conflicting results on the adenoma detection rate with narrow band imaging (NBI) compared with white light imaging (WLI). To overcome the confounding factors of these studies, we aimed to evaluate the colonic adenoma detection rate with primary NBI versus that with primary WLI by using consistent NBI system, endoscope, and imaging settings, and experienced colonoscopists.

Methods

In this multicenter prospective trial, 813 patients were randomized to undergo high-definition, tandem colonoscopy in the right colon with either NBI followed by WLI (NBI–WLI group) or WLI followed by NBI (WLI–NBI group). The NBI settings were fixed at surface structure enhancement level A-5 and adaptive index of hemoglobin color enhancement level 3. All detected polyps were resected or biopsied for histopathological analysis. The primary and secondary outcome measures were the adenoma detection rates and miss rates, respectively, with primary imaging.

Results

The NBI–WLI and WLI–NBI groups comprised 389 and 393 patients, respectively, who met the inclusion criteria. The groups did not differ significantly in age, gender, institution, indication for colonoscopy, bowel preparation, or observation time. The adenoma detection rates of primary NBI and WLI were 42.3 and 42.5 %, respectively [difference not significant (NS)]. The adenoma miss rate was significantly less with primary NBI than with primary WLI (21.3 vs. 27.8 %; p = 0.03).

Conclusions

NBI does not improve the adenoma detection rate during primary colonoscopy; however, it has a lower miss rate for adenoma lesions in the proximal colon than WLI.

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Acknowledgments

This paper was presented at the 18th United European Gastroenterology Week (UEGW), October 23–27, 2010, in Barcelona, Spain. This study was supported in part by Grant No. H21-009 from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Hiroaki Ikematsu & Kazuhiro Kaneko

  2. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

    Yutaka Saito & Takahisa Matsuda

  3. Department of Endoscopy, Hiroshima University, Hiroshima, Japan

    Shinji Tanaka & Shiro Oka

  4. Department of Endoscopy, Okayama University Hospital, Okayama, Japan

    Toshio Uraoka & Reiji Higashi

  5. Gastrointestinal Center, Sano Hospital, Kobe, Japan

    Yasushi Sano

  6. Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan

    Takahiro Horimatsu

  7. Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Osaka, Japan

    Hideki Ishikawa

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  1. Hiroaki Ikematsu
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  2. Yutaka Saito
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Correspondence to Hiroaki Ikematsu.

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Ikematsu, H., Saito, Y., Tanaka, S. et al. The impact of narrow band imaging for colon polyp detection: a multicenter randomized controlled trial by tandem colonoscopy. J Gastroenterol 47, 1099–1107 (2012). https://doi.org/10.1007/s00535-012-0575-2

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  • DOI: https://doi.org/10.1007/s00535-012-0575-2

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