Narrow Band Imaging For Detection Research Articles

Efficacy of magnifying endoscopy combined with narrowband imaging in detection of early gastric cancer: a systematic evaluation and meta-analysis.

To systematically evaluate the diagnostic accuracy of magnifying endoscopy combined with narrowband imaging (ME-NBI) in detecting early gastric cancer (EGC) and to provide a scientific basis for its clinical utility. Literature published before May 2024 that utilized ME-NBI for diagnosing EGC was searched across PubMed, EMBASE, The Cochrane Library, Web of Science, and major Chinese databases. Included studies were cohort studies or randomized controlled trials, and their quality was assessed using the QUADAS-2 framework. Meta-analysis was conducted using Stata 17 software to calculate diagnostic indicators such as sensitivity, specificity, and area under the curve (AUC). Heterogeneity was explored through Spearman's correlation coefficient, I2 statistics, subgroup analysis, and meta-regression analysis. Publication bias was assessed with Deeks' funnel plot. Twenty studies involving 7,770 patients and 7,917 lesions were included. The pooled sensitivity of ME-NBI for diagnosing EGC was 0.86 (95% CI: 0.80-0.90), specificity was 0.92 (95% CI: 0.86-0.96), and the AUC was 0.94 (95% CI: 0.91-0.96), demonstrating high diagnostic accuracy. Subgroup analysis revealed lower sensitivity in multicenter studies. Excised samples had similar sensitivity to biopsy samples but differed in specificity. Publication bias was detected (P=0.01), but sensitivity analysis corrected for this, maintaining high combined sensitivity, specificity, and AUC. ME-NBI is a highly accurate and reliable diagnostic tool for EGC. Despite have some bias and heterogeneity, this was effectively addressed through sensitivity and subgroup analyses. ME-NBI should be considered a preferred method for EGC screening and diagnosis in clinical practice.

Narrow band imaging in early diagnosis of laryngopharyngeal malignant and premalignant lesions

Objectives: (1) To assess the diagnostic accuracy of narrow-band imaging (NBI) in the assessment of benign, premalignant, and malignant vocal fold lesions. (2) To evaluate the diagnostic value of NBI in detection of recurrence in upper aero-digestive tract malignancy.Methods: This was a prospective, observational study done between December 2018- November 2019 in the Department of Otolaryngology. One hundred six patients of suspected benign, premalignant, malignant lesions of larynx and hypopharynx along with recurrence cases of upper aerodigestive tract malignancy who have completed chemoradiation therapy. All patients were subjected to white light endoscopy (WLE), NBI, and biopsy for histopathological diagnosis. In WLE, laryngeal lesions were classified into three types: malignant, suspected malignant, and benign. NBI images were classified into 5 types based on the intrapapillary capillary loop (IPCL) patterns: Type I-IV were considered benign and Type V lesion was considered malignant. At the end, WLE and NBI findings were correlated with histopathological reports.Results: The diagnostic accuracy of NBI in diagnosing benign, premalignant, and malignant lesions is significantly better than WLE. The sensitivity of NBI in detecting malignant lesions is significantly greater than WLE. NBI has proved to be of great value in identifying lesions that could be missed by WLE alone, as combined sensitivity of NBI and WLE is significantly higher than WLE alone.Conclusion: NBI is an excellent technique for early detection of laryngopharyngeal malignancies with significantly higher sensitivity than WLE alone.

Narrow band imaging for detection of gastric intestinal metaplasia and dysplasia: A systematic review and meta-analysis.

Gastric intestinal metaplasia (GIM), a precursor of gastric adenocarcinoma, is challenging to diagnose with white light endoscopy (WLE) and can be missed by random gastric biopsies. Narrowband imaging (NBI) may potentially improve the detection of GIM. However, pooled estimates from prospective studies are lacking. Electronic databases were searched for studies comparing NBI and WLE alone for detection of GIM and synchronous dysplasia. Primary outcome was pooled detection rate of GIM by NBI compared with WLE in prospective studies. The secondary outcome was concurrent dysplasia detection. Ten studies were found eligible from 306 articles screened. Eight prospective studies were found eligible for primary endpoint of GIM detection. Two other retrospective studies were included for dysplasia detection. A total of 1366 subjects (694 males, 54.4±5.08years) underwent upper endoscopy. GIM was detected in 482 (35.3%) subjects. NBI detected GIM in 32% additional subjects (70% vs 38%, RR 1.79; 95% CI 1.34-2.37; P<0.01). Subgroup analysis revealed newer NBI scopes (GIF260) detected significantly more GIM than WLE (RR 2.47; 95% CI 1.63-3.76; P<0.01) but not the older (H180) NBI endoscopes (RR 1.33; 95% CI 0.93-1.88; P=0.11). There was moderate heterogeneity between the studies (I2 =63%). In five studies (n=628) that reported dysplasia, there was no significant difference between NBI and WLE in dysplasia detection (RR 1.09; 95% CI 0.81-1.47; P=0.58). Narrowband imaging can significantly increase the detection of GIM when used in addition to standard white light exam during an upper endoscopy.

571 Diagnostic Accuracy of Narrow Band Imaging on Endoscopy in Detection of Duodenal Villous Atrophy Using Histopathology as a Gold Standard in Patients Presenting With Chronic Diarrhea

INTRODUCTION: Celiac disease and tropical sprue are common causes of chronic diarrhea &amp; duodenal villous atrophy (DVA). Narrow band imaging (NBI) is chromoendoscopic technique which facilitates detailed visualization of the mucosal surface &amp; allows targeted biopsy and thus increases the diagnostic yield of the biopsy specimen. Hence, we aimed to determine the diagnostic accuracy of NBI in detection of DVA using histopathology as a gold standard in chronic diarrhea patients. METHODS: All patients with diarrhea for &gt;4weeks were enrolled. Endoscopy was performed in all the patients to take duodenal biopsy and simultaneously NBI villous pattern was noted. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and diagnostic accuracy of NBI were calculated comparing histopathology. RESULTS: Baseline characteristics are shown in Table 1. NBI findings of total patients were finger shaped (normal villi), gyriform (partial villi atrophy) and flat surface (complete villous atrophy) mucosa as 22.6%, 59.7% and 17.7% respectively. NBI has sensitivity, specificity; PPV, NPV, and diagnostic accuracy were 84.9%, 45.2%, 82.3%, 50.0%, and 75% respectively for the detection of DVA as depicted in Table 2. CONCLUSION: This study showed 93 (75%) of participants had DVA in contrast to another study from Pakistan which revealed DVA in 49.8% of patients. This disparity is likely due to difference in study population. Our patients had normal villi, partial and complete villous atrophy in 31 (25%), 72 (58.1%) &amp; 21 (16.9%) respectively with P value 0.001. Dutta AK et al. found that NBI has sensitivity 81-87%, specificity 93%, NPV 96% and PPV 68-77% to detect DVA. We found sensitivity 85%, specificity 45%, NPV 50% &amp; PPV 82.3%. In our study specificity &amp; NPV were lower than in others as we included mild villous atrophy while most of the studies had a greater proportion of patients with moderate to severe villous atrophy. We found that duration of diarrhea is associated with presence of villous atrophy, as disease duration of &gt;5 months had sensitivity 92.1% and specificity 60% while 5 months had sensitivity &amp; specificity 80% &amp; 31.3% respectively. This association was not observed in previous studies. So we conclude NBI is a promising technique for assessment of duodenal mucosal details in patients with longstanding chronic diarrhea.

252 – A Prospective Randomized Tandem Colonoscopy Study of Linked Color Imaging Or Narrow Band Imaging for Detection of Colorectal Polyp

252 – A Prospective Randomized Tandem Colonoscopy Study of Linked Color Imaging Or Narrow Band Imaging for Detection of Colorectal Polyp

The Impact of Narrow Band Imaging in the Detection and Resection of Bladder Tumor in Transitional Cell Carcinoma of the Bladder: A Prospective, Blinded, Sequential Intervention Randomized Controlled Trial

To determine the impact of Narrow Band Imaging (NBI) in detection and resection of tumors during transurethral resection of bladder cancer. This was a single center randomized prospective interventional study with a sequential intervention design. Patients with bladder tumors were randomized into 2 arms where they were resected under white light (WL) first followed by NBI in arm A, or NBI followed by WL in arm B. The number of patients in whom additional lesions were detected by the second light source, in both arms, was analyzed. The feasibility of initial resection of tumor under NBI was also studied. A total of 110 patients were randomized. Of 54 patients in arm A (WL first) additional lesions were identified at the second look in 20 patients (37%). In contrast, of 56 patients in arm B (NBI first), additional lesions were identified in 5(9%) patients. This difference of 28% was statistically significant (P value <.001). In arm B (NBI first), there were 7 breaches in protocol, and all these patients had high risk (more than or equal to 3 in number or 3 cm in size) tumors (P value <.002). Narrowband imaging is superior to WL in the detection of tumors, thus allowing a more complete resection. However, initial resection under NBI is difficult due to poor visibility, especially for high-risk tumors.

Comparison of White Light, Photodynamic Diagnosis, and Narrow-band Imaging in Detection of Carcinoma In Situ or Flat Dysplasia at Transurethral Resection of the Bladder: the DaBlaCa-8 Study

To compare findings in NBI to findings in WL and PDD in a high-risk patient population. A total of 171 patients were included in the study from 4 different urology departments in Denmark and Norway. Patients were scheduled for a PDD-guided transurethral tumor resection or cystoscopy-guided biopsy in accordance with Danish guidelines, on the suspicion of primary or concomitant CIS. All patients were examined with WL cystoscopy followed by both NBI and PDD before biopsy. A total of 136 patients were biopsied due to findings with suspicion of CIS in at least 1 modality (482 biopsies with a mean of 3.5 biopsies per patient). Analysis at patient level showed that NBI and PDD had a significantly higher sensitivity regarding identification of CIS and dysplasia compared with WL (NBI: 95.7%, PDD: 95.7% vs WL: 65.2%, P < .05). Specificity was not significantly different between the 3 methods (NBI: 52.0%, PDD: 48.0%, and WL: 56.8%). When analyzed per biopsy, NBI and PDD had a significantly higher sensitivity than WL (NBI: 72.7% and PDD: 78.2% vs WL: 52.7%, P < .05), whereas the positive predictive values were not significantly different (NBI: 23.7%, PDD: 22.2%, and WL: 19.0%). NBI was found to be a valid alternative to PDD regarding diagnosis of CIS and flat dysplasia.

NBI併用拡大内視鏡で診断できた胃過形成性ポリープ由来の早期胃癌の1例

NBI併用拡大内視鏡で診断できた胃過形成性ポリープ由来の早期胃癌の1例

A multicenter randomized comparison between high-definition white light endoscopy and narrow band imaging for detection of gastric lesions.

Narrow band imaging (NBI) is generally considered to be useful for lesion characterization, but not enhanced detection of gastric lesions, because of the dark endoscopic view. We tested whether the new generation of NBI (190-NBI or 290-NBI), which is twice as bright as the previous version, would improve detection of premalignant gastric lesions compared with high-definition white light endoscopy (HD-WLE). This was a multicenter prospective randomized study involving five tertiary institutions in the Asia-Pacific region. A total of 579 patients aged older than 50 years who underwent diagnostic upper gastrointestinal endoscopy were randomized to either HD-WLE or NBI. The outcome measurements were detection of intestinal metaplasia (IM), focal gastric lesions, and gastric cancers. Focal gastric lesions were detected in 83/286 (29%) and 119/293 patients (40.6%) by HD-WLE and by NBI, respectively (P=0.003). IM was detected in 22/286 patients (7.7%) by HD-WLE and in 52/293 patients (17.7%) by NBI (P<0.001). Gastric cancer were found in 7/286 (2.4%) and 3/293 patients (1%) in HD-WLE and NBI groups, respectively (P=0.189). NBI increased the detection rate of IM compared with HD-WLE.

Laparoscopic narrow band imaging for detection of occult cancer metastases: a randomized feasibility trial.

Selection of cancer treatment fundamentally relies on staging of the underlying malignancy. The aim of this study was to evaluate the feasibility and effectiveness of laparoscopic narrow band imaging (NBI) for operative staging and detection of occult peritoneal cancer metastases. A randomized, controlled feasibility trial with crossover design evaluating adult patients with gastrointestinal or gynecologic malignancies who have a clinical indication for diagnostic laparoscopy was conducted. Twenty-three patients were randomized to white-light followed by NBI laparoscopy (n = 11) or NBI followed by white-light laparoscopy (n = 12) using the Olympus Evis Exera II system. Three patients were excluded from analysis. In all 20 study patients, the abdominal cavity was sufficiently illuminated. An enhanced contrast of microvasculature and organ surface pattern was appreciated. Eight of the 20 patients (40%) were found to have metastases of the peritoneal surface. While NBI did not show any additional peritoneal lesions, 2 of the 63 suspicious-appearing nodules seen on white-light imaging were not visible on NBI (p = 0.50). The median diameter of all the nodules identified was 2 mm (range 1-50 mm) and was identical with each method. The information from this feasibility study demonstrated that NBI provides adequate illumination of the abdominal cavity and a unique contrast that enhances microvasculature and architectural surface pattern. The results suggest that NBI laparoscopy is not superior in detecting peritoneal metastases compared to standard white-light laparoscopy, but might provide a technology that could be applied for other abdominal pathologies.

Preliminary study of combined use of PDD and NBI for detection for flat urothelial lesion.

340 Background: This prospective preliminary study is a first report to compare photodynamic diagnosis (PDD) with narrow band imaging (NBI) in the same patients with flat suspicious lesions of carcinoma in situ (CIS) of bladder. Methods: PDD was approved by the ethics committees of our institution for 10 patients with non muscle invasive bladder cancer. Between November 2012 and April 2013, 10 patients with abnormal cytology (class III or more) but undefined papillary mucosa underwent TURBT using PDD and NBI in same time. Each patient received 1.0g ALA hydrochloride (Cosmo Bio Co., Tokyo, Japan) dissolved in 50 mL water, and was given orally 3 hours before the TURBT. The bladder was mapped first under white light (WL), then under NBI, and subsequently under blue light (BL) in odd-numbered patients. The bladder was mapped first under WL, then under BL, and subsequently under NBI in even- numbered patients. Biopsies were carried out from all suspicious areas noting if NBI, PDD or both detected lesions. Random cold cup biopsies were performed from negative lesions of PDD and NBI. Results: The sensitivity and specificity of PDD for detection CIS were 1.00 and 0.714, and those of NBI were 0.75 and 0.814, respectively. There were no cancer and dysplasia in 43 lesions both PDD and NBI negative. Of 50 lesions with negative PDD, only 2 (4%) were dysplasia and there was no cancerous lesion. Of 60 lesions with negative NBI, 3 (5%) were cancer and 6 (10%) were dysplasia. The AUC for detection CIS in PDD, in NBI and in combined use of PDD and NBI were 0.869, 0.782 and 0.964, respectively. Conclusions: When both PDD and NBI were negative, the possibility of CIS might be very low. The usefulness of the combination of PDD with NBI was suggested in this study. [Table: see text]

Initial experience of combined use of photodynamic diagnosis and narrow band imaging for detection of flat urothelial lesion.

This preliminary study is the first report to compare photodynamic diagnosis (PDD) with narrow band imaging (NBI) in the same patients with flat urothelial lesions suspicious of carcinoma in situ (CIS) of the bladder. Between November 26, 2012 and April 1, 2013, 10 patients underwent transurethral resection of bladder tumor using PDD and NBI simultaneously because of suspicion of CIS. The bladder was mapped first under white light (WL), then under NBI, and subsequently under blue light in odd-numbered patients. The bladder was mapped first under WL, then under blue light, and subsequently under NBI in even-numbered patients. Biopsies were carried out from all suspicious areas, noting whether NBI, PDD or both detected lesions. Random cold cup biopsies from healthy mucosa of bladder were performed from lesions negative on PDD and NBI. The sensitivity and specificity of PDD for detection of CIS and dysplasia were 0.916 and 0.827, respectively. The sensitivity and specificity of NBI for detection of CIS and dysplasia were 0.625 and 0.879. The area under the curve (AUC) for detection of CIS and dysplasia was 0.872 with PDD and 0.752 with NBI. The AUC with combined use of PDD and NBI was 0.918. There was no cancer or dysplasia identified in 43 lesions that were both PDD- and NBI-negative. When both PDD and NBI are negative, the possibility of CIS or dysplasia might be very low. The usefulness of the combination of PDD with NBI was suggested in this study.

Narrow band imaging facilitates detection of inlet patches in the cervical oesophagus.

Proximal esophageal heterotopic gastric mucosa or so-called inlet patch in the cervical oesophagus is easily missed on endoscopic examination because of its localisation, usually just below the upper oesophageal sphincter. We evaluated the clinical use of narrow band imaging for detection of inlet patches. In this prospective, controlled observational study, 1407 subsequent patients underwent oesophagogastroduodenoscopy with or without narrow band imaging on withdrawal of the endoscope in the cervical oesophagus. One endoscopist who was not aware of the prospective observation documented 6 (1.17%) cases of inlet patches in 515 oesophagogastroduodenoscopies compared to 4 cases out of 382 (1.05%) performed by the endoscopist who paid special attention to the presence of inlet patches but did not routinely apply narrow band imaging (OR 0.89, CI 95% 0.25-3.20, p=0.85). In comparison, 17 cases of inlet patches out of 510 (3.33%) were detected by the endoscopist who routinely applied narrow band imaging. The detection rate of proximal oesophageal heterotopic gastric mucosa using narrow band imaging was significantly higher compared to white light endoscopy only (OR 3.06, CI 95% 1.39-6.73, p=0.005). Withdrawal of the endoscope from the cervical oesophagus using narrow band imaging increased the detection of inlet patches about three-fold compared to standard white light endoscopy.

Use of narrow-band imaging in detection of nasopharyngeal carcinoma

To compare narrow-band images of nasopharyngeal carcinoma with those of normal adenoidal tissue. Patients with a nasopharyngeal mass were evaluated using both conventional white light and narrow-band light. Biopsies were performed and Epstein-Barr viral serology was tested for all patients. Thirty consecutive patients were recruited. Twenty-one patients had normal adenoidal tissue and seven had nasopharyngeal carcinoma. One patient with papillary adenocarcinoma was excluded. The features of narrow-band imaging in normal adenoidal tissue were: (1) a regularly arranged follicular pattern, and (2) each 'follicle' comprising a pale centre with surrounding dark periphery. The features of narrow-band imaging in nasopharyngeal carcinoma were: (1) absence of surface patterns (n = 7), and/or (2) 'reverse', haphazard follicular pattern comprising a dark brown centre and pale periphery (n = 3). Narrow-band imaging of the surface of adenoidal tissue and nasopharyngeal carcinoma appears to identify distinct, characteristic features as described. Narrow-band imaging may be a useful adjunct in differentiating normal adenoidal tissue from malignancy. Further studies are needed to evaluate its diagnostic accuracy.

NBI and NBI Combined with Magnifying Colonoscopy

Although magnifying chromoendoscopy had been a reliable diagnostic tool, narrow-band imaging (NBI) has been developed in Japan since 1999 and has now replaced the major role of chromoendoscopy because of its convenience and simplicity. In this paper, we principally describe the efficacy of magnifying chromoendoscopy and magnifying colonoscopy with NBI for detection, histological prediction, estimation of the depth of early colorectal cancer, and future prospects. Although some meta-analyses have concluded that NBI is not superior to white light imaging for detection of adenomatous polyps in screening colonoscopy, NBI with magnification colonoscopy is useful for histological prediction, or for estimating the depth of invasion. To standardize these diagnostic strategies, we will focus on the NBI International Colorectal Endoscopic (NICE) classification proposed for use by endoscopists with or without a magnifying endoscope. However, more prospective research is needed to prove that this classification can be applied with satisfactory availability, feasibility, and reliability. In the future, NBI might contribute to the evaluation of real-time histological prediction during colonoscopy, which has substantial benefits for both reducing the risk of polypectomy and saving the cost of histological evaluation by resecting and discarding diminutive adenomatous polyps (resect and discard strategy).

Narrow Band Imaging for Detection of Dysplasia in Colitis: A Randomized Controlled Trial

In ulcerative colitis surveillance, chromoendoscopy improves dysplasia detection 3 – 5-fold compared with white light endoscopy (WLE). The aim of this study was to investigate whether narrow band imaging (NBI) can improve dysplasia detection compared with WLE. This was a randomized, parallel-group trial. A total of 220 patients were needed to be recruited to detect a threefold increase in dysplasia detection. In all, 112 patients with long-standing ulcerative colitis were randomized to colonoscopic extubation with NBI (56) or WLE (56) (1:1 ratio) at two tertiary endoscopy units in the United Kingdom. Targeted biopsies of suspicious areas and quadrantic random biopsies every 10 cm were taken in both groups. The primary outcome measure was the proportion of patients with at least one area of dysplasia detected. In a prespecified mid-point analysis, the criteria for trial discontinuation were met and the trial was stopped and analyzed at this point. There was no difference in the primary outcome between the two groups, with 5 patients having at least one dysplastic lesion in each group (odds ratio (OR) 1.00, 95 % confidence interval (95 % CI) 0.27 – 3.67, P = 1.00). This remained unchanged when adjusted for other variables (OR 0.69, 95 % CI 0.16 – 2.96, P = 0.62). Overall, dysplasia detection was 9 % in each arm. Yield of dysplasia from random nontargeted biopsies was 1 / 2,707 (0.04 % ). Overall, in this multicenter parallel-group trial, there was no difference in dysplasia detection when using NBI compared with high-definition WLE colonoscopy. Random background biopsies were ineffective in detecting dysplasia.

Magnified Endoscopy Combined with Narrow Band Imaging of Minimal Superficial Esophageal Neoplasia—Indicators to Differentiate Intraepithelial Neoplasias

PurposeClinical application of narrow band imaging facilitates diagnosis of esophageal neoplasia. However, no previous investigation has been conducted on magnifying endoscopy combined with narrow band imaging in detection of minimal superficial esophageal neoplasia, which is defined as neoplasia <10 mm in diameter. The aim of this retrospective study was to evaluate the usefulness of this combined technique in the differential diagnosis of minimal superficial esophageal neoplasia.MethodsBetween January 2005 and November 2011, 53 minimal superficial esophageal neoplasias in 40 patients were diagnosed by screening upper gastrointestinal endoscopy with narrow band imaging at our hospital. We investigated findings including brownish dots, brownish epithelium, and demarcation line of minimal superficial esophageal neoplasia diagnosed histopathologically as low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, and squamous cell carcinoma.ResultsSignificantly more brownish dots (P < 0.05) and brownish epithelium (P < 0.005) were observed in intraepithelial papillary capillary loops in high-grade neoplasia compared with low-grade neoplasia. When minimal superficial esophageal neoplasia was diagnosed as high-grade intraepithelial neoplasia or squamous cell carcinoma, sensitivity, specificity, positive predictive value, and negative predictive value were 88.9, 42.9, 44.4, and 88.2 %, respectively, for brownish dots; 94.4, 51.4, 50.0, and 94.7 %, respectively, for brownish epithelium; and 66.7, 62.9, 48.0, and 78.6 %, respectively, for demarcation line.ConclusionsThe combined technique was useful in the differential diagnosis of minimal superficial esophageal neoplasia.

Diagnostic Accuracy of Probe-based Confocal Laser Endomicroscopy and Narrow Band Imaging in Detection of Dysplasia in Duodenal Polyps

To estimate the accuracy of probe-based confocal laser endomicroscopy (pCLE) and narrow band imaging (NBI), individually and in combination, for classification of duodenal polyps. Ex vivo pathologic diagnosis of duodenal polyps causes time delay, requiring separate procedures for diagnosis and therapy. It also involves small risk of pancreatitis in ampullary adenomas and can make subsequent endoscopic mucosal resection more difficult by "tacking down" mucosa. In vivo diagnosis with pCLE and NBI may avoid these complications and may guide immediate therapy. During high-definition white light endoscopy, 1 endoscopist (M.B.W.) performed NBI and then, pCLE of duodenal sites. Matched tissue sampling or endoscopic mucosal resection was performed. Confocal videos were recorded, de-identified, and reviewed by same endoscopist, blinded to histopathology, 1 month later. Confocal features of dysplasia in Barrett esophagus were applied for detection of duodenal dysplasia. Of 65 sites from 36 participants, 24 lesions showed dysplasia, whereas 41 polyps and control sites were nondysplastic on histopathology, used as standard reference. The accuracy, sensitivity, and specificity of pCLE were 83%, 92%, and 78%, whereas that of NBI were 80%, 83%, and 78%, respectively. In subset of 49 lesions with similar pCLE and NBI diagnosis, the accuracy, sensitivity, and specificity, improved significantly and was found to be 92%, 95%, and 90%, respectively. Our study suggests that pCLE has superior sensitivity as compared with NBI for detection of dysplasia in duodenal polyps. Combined accuracy of pCLE and NBI approaches that of ex vivo pathology, which may help in avoiding biopsy sampling.

Mo1523 A Japanese Multicenter Randomized Controlled Trial Using Narrow-Band Imaging for Detection of Colorectal Adenomas

Mo1523 A Japanese Multicenter Randomized Controlled Trial Using Narrow-Band Imaging for Detection of Colorectal Adenomas

SURVEILLANCE COLONOSCOPY USING A TRANSPARENT HOOD AND IMAGE‐ENHANCED ENDOSCOPY

Colonoscopists can miss adenomas during colonoscopy screening. A transparent hood attached to the tip of the colonoscope helps detection of colorectal adenomas, but as far as we are aware, there has been no trial indicating its statistically significant effectiveness. Total colonic dye spray might improve the adenoma detection rate but it is complicated and time-consuming for routine clinical usage. Moreover, the efficacy of narrow band imaging for detection of colorectal adenoma is controversial and is still under debate. Autofluorescence imaging (AFI) might be better able to detect flat lesions than white light imaging (WLI), but its ability is influenced easily by the area of the observation. Therefore, we have attached a transparent hood to the tip of an AFI colonoscope during colonoscopy screening in clinical usage. AFI can detect a flat lesion, which is difficult to detect using WLI. A transparent hood can help to detect lesions behind the folds by pushing the colonic fold. We expect that mounting a transparent hood would work complimentary to AFI. Further improvements, including a combination of AFI and a transparent hood, are needed and they would provide optimal surveillance intervals.