Quick and Comprehensive Assessment of Narrow Band Imaging (NBI) Using in Digestive Tract Examination

Abstract

Narrow Band Imaging (NBI) could filter red light during endoscopy compared to white light imaging (WLI), which could reduce interference effect on imaging. The objective of this research is evaluating clinical effect and cost-effectiveness of NBI in digestive tract examination. National report about NBI used for gastric cancer and colorectal cancer were collected from health technology assessment institutions such as NICE, ASGE, and CBER. We also searched literature database included PubMed, Cochrane Library and Embase, collecting researches about NBI used for gastric cancer and colorectal cancer. Clinical effect and cost-effectiveness of NBI were evaluated from the results of national report and literatures. For colorectal cancer, 8 reports from NICE, 6 reports from ASGE and 16 papers were included. Among national reports, 4 of 7 clinical trials illustrated NBI has better imaging effect (accuracy, sensitivity, specificity) than WLI in colorectal lesions diagnosis. 2 of 3 meta-analysis showed NBI has good imaging effect and 3 clinical guidelines suggest NBI using in observing mucosal surface of colorectal polyps. 8 of clinical trials among literatures demonstrated outstanding imaging effect for colorectal lesions. 3 reports and 2 literatures mentioned economy of NBI, which showed a result of cost reduction with a Resect and Discard Strategy in colorectal cancer screening using NBI. For gastric cancer, 5 reports (NICE: 4 ASGE: 1) and 22 literatures were included. The 5 reports (1 guidelines, 1 clinical trials, 2 meta-analysis and 1 technologic report) showed NBI has better effect in early gastric cancer (EGC) than WLI. All literature affirmed imaging effect of NBI, especially in EGC test. From results of reports and literatures, we concluded NBI using in colorectal lesions screening could had better effect with lower cost. Besides, NBI could be used in EGC screening for the brilliant imaging effect.