Specificity Of Narrow Band Imaging Research Articles

The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer.

IntroductionNarrowband imaging (NBI) is a special endoscopic optical enhancement setting allowing better visualization of mucosal microvasculature compared to white light endoscopy. This study evaluates the validity of NBI using the Ni classification in the detection and differentiation of severe dysplasia (SD) and glottic squamous cell carcinoma (SCC).MethodsPatients with suspicious vocal cord lesions underwent conventional white light endoscopy followed by clinically indicated biopsy. At the same time, NBI images were obtained and graded independently. Lesions were graded from I to V according to the Ni classification and compared to histopathological findings.ResultsFifty‐two patients were included in this study (40 SCC and 12 SD). The sensitivity and specificity of NBI in diagnosing laryngeal cancer was 95.0% (CI, 83.9%‐99.4%) and 83.3% (CI, 51.6%‐97.9%), respectively. The negative likelihood ratio was 0.06. Higher Ni grades correlated very strongly with more advanced disease.ConclusionsNBI using the Ni classification is a sensitive diagnostic tool for the detection and differentiation of early neoplastic and preneoplastic glottic lesions. As higher Ni classification correlates strongly with advanced disease, it serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal cancer.Level of Evidence: Level IV.

Narrow band imaging in head and neck unknown primary carcinoma: A systematic review and meta-analysis.

To estimate the diagnostic performance of Narrow Band Imaging (NBI) in patients with cervical metastasis from head and neck squamous cell carcinoma of unknown primary (SCCUP) origin. PubMed, Embase, and Scopus databases were systematically scrutinized up to July 1, 2019, looking for studies that encompassed the NBI in the SCCUP diagnostic work up. The main inclusion criteria for eligible articles for the meta-analysis were non-evidence of primary tumor after physical examination and conventional cross-section imaging before NBI assessment and the availability of complete data on the diagnostic accuracy of NBI. A set of random-effects model meta-analyses was then performed following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Five studies, conducted between January 2003 and September 2016, comprising 169 patients imaged with NBI, were included in the meta-analysis. The pooled sensitivity and specificity of NBI in patients with head and neck SCCUP was 0.83 (99% CI, 0.54-0.95) and 0.88 (99% CI, 0.55-0.97), respectively. The positive and negative likelihood ratios were 6.38 (99% CI, 1.6-25.44) and 0.06 (99% CI, 0.005-0.86). The pooled diagnostic odds ratio (DOR) was 82.15 (99% CI, 7.06-955). The overall detection rate of NBI was 0.35 (99% CI, 0.18-0.53), which allowed localization the primary tumor in 61 out of 169 patients, otherwise not detected by the usual diagnostic work-up. Current available evidence suggests that NBI has a considerable diagnostic accuracy in patients affected by head and neck SCCUP. Laryngoscope, 130:1692-1700, 2020.

The feasibility of NBI in patients with suspected upper airway lesions: A multicenter study.

Narrow band imaging (NBI) improves diagnosis of laryngopharyngeal cancer, but most reported NBI studies are from experienced centers. Feasibility reports on use at everyday outpatient departments are needed. Researcher-initiated, prospective, multicenter. Participating physicians were instructed in NBI technique during a 4-hour meeting. Patients underwent an examination that included endoscopy with white light (WL) high-definition (HD) TV and NBI filter in the selected time period. All suspicious lesions were biopsied. The medical records of patients with NBI negative findings were evaluated 6 months after the visit to detect all possible malignant lesions coming into view at mucosal sites. These were considered as false-negative cases, enabling long-term assess to the positive predictive value (NPV) of the protocol. We enrolled 125 patients. Of those, 84 (67.2%) were males and the median age was 65 years (range, 35-91). In analysis of the accuracy of WL HD TV and NBI against biopsy, the sensitivity and specificity of WL HD TV were 62% and 81%, respectively; and the sensitivity and specificity of NBI were 100% and 84%, respectively. The diagnostic accuracy of NBI was significantly better (P < 0.05). When analyzing medical records 6 months after the initial examination, we found three patients who had been diagnosed with a malignant lesion (NPV of NBI of 96.8%). Narrow band imaging is readily implemented in an everyday outpatient practice, and there seems to be better detection rates of dysplastic/carcinoma lesions with HD NBI compared to HD WL. 2b. Laryngoscope, 127:1821-1825, 2017.

Decision Based on Narrow Band Imaging Cystoscopy without a Referential Normal Standard Rather Increases Unnecessary Biopsy in Detection of Recurrent Bladder Urothelial Carcinoma Early after Intravesical Instillation.

PurposeThe purpose of this study was to calculate the operating characteristics of narrowband imaging (NBI) cystoscopy versus traditional white light cystoscopy (WLC) in common clinical scenarios involving suspicion of bladder urothelial carcinoma (UC).Materials and MethodsSixty-three consecutive patients initially underwent WLC and then NBI in a single session for evaluation of microscopic hematuria (group I, n=20), gross hematuria (group II, n=19), and follow-up for prior UC (group III, n=24), by an experienced urologist. All lesions that were abnormal in contrast with adjacent normal mucosa were diagnosed as positive and biopsied.ResultsSixty-six biopsies from 47 patients were performed. Pathologic examination showed 17 cases of UC from 21 sites. While the overall sensitivity of NBI was similar to that of WLC (100% vs. 94.1%), the specificity of NBI was significantly lower than that of WLC (50% vs. 86.9%, p < 0.001), particularly in group III (38.9% vs. 88.9%, p=0.004). Based on identification by NBI only, 23 additional biopsies from 18 cases were performed for identification of one patient with UC, who belonged to group III. In this group, to identify this specific patient, 15 additional biopsies were performed from 10 patients. All seven cases with positive findings from NBI within 2 months after the last intravesical therapy were histologically proven as negative.ConclusionIn evaluation for recurrence early after intravesical instillation, the decision based on NBI increased unnecessary biopsy in the absence of an established standard for judging NBI.

OI0306 Does narrow band imaging add value in oral medicine?

The study of angiogenesis, an early and key event in carcinogenesis, could improve early detection of malignant/premalignant oral lesions. Narrow band imaging (NBI) is an optical technique that is used both to perform objective examination of the oral cavity, with the aid of different grades of magnification, and to visualize intrapapillary capillary loops (IPCLs) through a 415-nm light source. The aim of this study was (1) to define the sensitivity and specificity of NBI in detecting dysplastic and neoplastic lesions and (2) to evaluate its learning curve.

Meta-Analysis: Narrow Band Imaging for Diagnosis of Gastric Intestinal Metaplasia

BackgroundDistinguishing early gastric cancer is challenging with current imaging techniques. Narrow band imaging (NBI) is effective for characterizing gastric lesions.ObjectivesThe aim of this meta-analysis was to estimate the diagnostic accuracy of NBI in the gastric intestinal metaplasia (GIM).MethodsWe performed data analysis using Meta-DiSc (version 1.4) and STATA (version 11.0) software. To assess study quality and potential for bias, we used the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.ResultsSix studies involving 347 patients were included. On a per-patient basis, the sensitivity of NBI for diagnosis of GIM was 0.65 (95% CI = 0.56–0.74), and the specificity was 0.93 (95% CI = 0.88–0.97). The area under the summary receiver operating characteristic (SROC) curve was 0.8731. However, on a per-lesion basis, the sensitivity and specificity of NBI were 0.69 (95% CI = 0.63–0.74) and 0.91 (95% CI = 0.87–0.94), respectively. The SROC was 0.9009. The pooled sensitivity and specificity of magnification endoscopy (NBI-ME) were 0.76 (95% CI = 0.61–0.87) and 0.89 (95% CI = 0.80–0.94), respectively, on per-patient analysis. On a per-lesion basis, the pooled sensitivity and specificity of NBI-ME were 0.84 (95% CI = 0.76–0.89) and 0.93 (95% CI = 0.89–0.96), respectively. Heterogeneity was observed with an I2 for diagnostic odds ratio (DOR) of 0.01% and 85.8%, respectively. There was no statistical significance for the evaluation of publication bias.ConclusionsOur meta-analysis shows that NBI is a useful tool for differential diagnosis of GIM with relatively low sensitivity and high specificity.

Duodenal villous morphology assessed using magnification narrow band imaging correlates well with histology in patients with suspected malabsorption syndrome

Narrow band imaging with magnification enables detailed assessment of duodenal villi and may be useful in predicting the presence of villous atrophy or normal villi. We aimed to assess the morphology of duodenal villi using magnification narrow band imaging and correlate it with histology findings in patients with clinically suspected malabsorption syndrome. Patients with clinical suspicion of malabsorption presenting at a tertiary care center were prospectively recruited in this diagnostic intervention study. Patients underwent upper gastrointestinal endoscopy using magnification narrow band imaging. The villous morphology in the second part of the duodenum was assessed independently by two endoscopists and the presence of normal or atrophic villi was recorded. Biopsy specimen was obtained from the same area and was examined by two pathologists together. The sensitivity and specificity of magnification narrow band imaging in detecting the presence of duodenal villous atrophy was calculated and compared to the histology. One hundred patients with clinically suspected malabsorption were included in this study. Sixteen patients had histologically confirmed villous atrophy. The sensitivity and specificity of narrow band imaging in predicting villous atrophy was 87.5% and 95.2%, respectively, for one endoscopist. The corresponding figures for the second endoscopist were 81.3% and 92.9%, respectively. The interobserver agreement was very good with a kappa value of 0.87. Magnification narrow band imaging performed very well in predicting duodenal villous morphology. This may help in carrying out targeted biopsies and avoiding unnecessary biopsies in patients with suspected malabsorption.

Combination of narrow band imaging (NBI) and autofluorescence bronchoscopy (AFB) in the assessment of central lung cancer

To assess the diagnostic value of narrow-band imaging(NBI) in the diagnosis of central lung cancer. Patients (n = 153) suspected of having lung cancer underwent white light bronchoscopy(WLB), NBI and autofluorescence bronchoscopy(AFB) in turn. At least 3 biopsies in each case were taken from sites visualized as lesions. The sensitivity and specificity of NBI, AFB and combination of NBI and AFB were compared. There were 106 male (69.3%) and 47 female patients (30.7%). By NBI, 91 and 62 cases were positive and negative respectively. The sensitivity and specificity of NBI were 63.5% (87/137) and 75.0% (12/16) respectively. By AFB, 140 and 13 cases were positive and negative respectively. The sensitivity and specificity of AFB were 94.2% (129/137) and 87.5% (5/16) respectively. By NBI combined with AFB, 133 and 20 cases were positive and negative respectively, the sensitivity and specificity being 95.6% (131/137) and 87.5% (14/16) respectively. The difference of specificity between NBI plus AFB and AFB alone was significant (P < 0.01), but the difference of sensitivity between NBI plus AFB and AFB alone(P > 0.05) was not. The difference of specificity between NBI plus AFB and NBI alone was significant (P < 0.01), but the P value of specificity between NBI plus AFB and NBI was 0.03. Combination of NBI and AFB could increase the specificity of lung cancer diagnosis compared to AFB alone.

Diagnostic accuracy of narrow band imaging for predicting colon polyp histology can be affected by polyp characteristics.

Narrow band imaging (NBI) is an optical endoscopic technique for predicting polyp histology during colonoscopy. However, it has not been elucidated the impact of polyp characteristics on the diagnostic capabilities of NBI. We aimed to evaluate which polyp characteristics can influence the diagnostic accuracy of NBI for discriminating neoplastic from non-neoplastic colorectal polyps. A total of 232 colorectal polyps from 134 patients undergoing screening or surveillance colonoscopy were retrospectively analyzed. White light imaging (WLI) and NBI images of polyps were assessed by two experienced endoscopists and two trainees and then compared with histopathology. When classified according to polyp morphology, NBI as well as WLI had a significantly lower sensitivity and diagnostic accuracy for non-polypoid lesions than for polypoid lesions in both experienced and trainee groups. In contrast, the specificity of NBI and WLI for non-polypoid lesions was higher than that for polpyoid lesions. As for polyp size, the diagnostic accuracy of NBI for polyps ≤5mm was significantly lower than for polyps of 6 to 9mm or ≤10mm in the experienced group. NBI had a significantly lower diagnostic accuracy for predicting polyp histology in non-polypoid or diminutive colorectal lesions.

PTU-156 The Combination of Autofluorescence Imaging and Probe-Based Confocal Laser Endomicroscopy has an Excellent Diagnostic Accuracy for Dysplasia in Barrett’S Esophagus

IntroductionEndoscopic surveillance in Barrett’s oesophagus (BO) has major limitations including sampling error due to inconspicuous dysplasia, need for multiple biopsies and subjectivity of pathological assessment of dysplasia. Probe-based confocal laser...

Detection of premalignant bronchial lesions can be significantly improved by combination of advanced bronchoscopic imaging techniques

BACKGROUND:The search for the most efficient bronchoscopic imaging tool in detection of early lung cancer is still active. The major aim of this study was to determine sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each bronchoscopic technique and their combination in detection of premalignant bronchial lesions.METHODS:This was a prospective trial that enrolled 96 patients with indication for bronchoscopy. Lesions were classified as visually positive if pathological fluorescence was observed under autofluorescence imaging (AFI) videobronchoscopy or dotted, tortuous, and abrupt-ending blood vessels were identified under narrow band imaging (NBI) videobronchoscopy. Squamous metaplasia, mild, moderate, or severe dysplasia, and carcinoma in situ (CIS) were regarded as histologically positive lesions.RESULTS:Sensitivity, specificity, PPV, and NPV of white light videobronchoscopy (WLB) in detection of premalignant lesions were 26.5%, 63.9%, 34.4%, and 54.9%, respectively; the corresponding values for AFI were 52%, 79.6%, 64.6%, and 69.9% respectively, for NBI were 66%, 84.6%, 75.4%, 77.7%, respectively, while the values for combination of NBI and AFI were 86.1%, 86.6%, 84.6%, and 88%, respectively. Combination of NBI and AFI significantly improves sensitivity when compared to each individual technique (P < 0.001). When specificity is of concern, combination of techniques improves specificity of WLB (P < 0.001) and specificity of AFI (P = 0.03), but it does not have significant influence on specificity of NBI (P = 0.53).CONCLUSION:Combination of NBI and AFI in detection of premalignant bronchial lesions increases both sensitivity and specificity of each technique. However, it seems that NBI is most sufficient and effective in detection of these lesions.

Is it proper to use non‐magnified narrow‐band imaging for esophageal neoplasia screening? Japanese single‐center, prospective study

Most screening examinations in Japanese general hospitals are carried out by high-definition television-incompatible (non-HD) scopes and non-magnifying endoscopes. We evaluated the narrow-band imaging (NBI) real-time diagnostic yield of esophageal neoplasia in high-risk patients at a general hospital. In a single-center, prospective, non-randomized controlled trial, 117 consecutive screening patients with high risk for esophageal cancer received primary white-light imaging (WLI) followed by NBI and iodine-staining endoscopy (59 by HDTV-compatible [HD] endoscopy and 58 by non-HD endoscopy). The primary aim was to evaluate the diagnostic yield of non-magnified images in diagnosing esophageal neoplasia. The secondary aim was to compare HD endoscopy and non-HD endoscopy in terms of diagnostic performance. Overall, the sensitivity of NBI for screening of esophageal neoplasia was superior to WLI, and equivalent to iodine staining (92% vs 42%; P < 0.05, 92% vs 100%; ns). The specificity of NBI was equivalent to WLI (89% vs 94%; ns). In HD, NBI sensitivity was equivalent to both iodine staining and WLI (100% vs 75%; ns). In non-HD, NBI sensitivity was equivalent to iodine staining, but WLI sensitivity was significantly inferior to NBI (88% vs 100%; ns, 25% vs 88%; P < 0.05). The NBI specificity was equivalent to WLI not only in HD but also in non-HD (90% vs 96%; ns, 88% vs 93%; ns). In both HD and non-HD endoscopy, NBI is less likely than WLI to miss a lesion. Even with non-HD endoscopy, NBI is suitable for esophageal standard examinations in general hospitals.

Early Detection of Carcinoma In Situ of the Bladder: A Comparative Study of White Light Cystoscopy, Narrow Band Imaging, 5-ALA Fluorescence Cystoscopy and 3-Dimensional Optical Coherence Tomography

We compared the efficacy and potential limitations of white light cystoscopy, narrow band imaging, 5-ALA fluorescence cystoscopy and 3-dimensional optical coherence tomography for early diagnosis of bladder carcinoma in situ. By expressing simian virus 40T antigen in the urothelium carcinoma in situ typically develops in SV40T transgenic mice in about 8 to 20 weeks and then frank high grade papillary urothelial carcinoma starts to emerge. A total of 18 control and 29 SV40T mice were examined during weeks 8 to 22 by white light cystoscopy, fluorescence cystoscopy, narrow band imaging and 3-dimensional optical coherence tomography. Results were validated by histology. Newly improved algorithms for computer aided detection were applied to acquired 3-dimensional optical coherence tomography images to enhance the quantitative diagnosis of carcinoma in situ in near real time. Of 29 carcinoma in situ samples 27 were detected by 3-dimensional optical coherence tomography, 1 by white light cystoscopy, 26 by narrow band imaging and 13 by fluorescence cystoscopy. Of the 18 histologically confirmed benign cases 17 were detected by 3-dimensional optical coherence tomography, 14 by white light cystoscopy, 5 by narrow band imaging and 18 by fluorescence cystoscopy. The diagnostic sensitivity of white light cystoscopy (3.4%) and fluorescence cystoscopy (44.8%), and the specificity of narrow band imaging (27.8%) were significantly enhanced by 3-dimensional optical coherence tomography to 93.1% and 94.4%, respectively (p <0.01). Three-dimensional optical coherence tomography with quantitative computer aided detection can significantly enhance the sensitivity of white light cystoscopy and fluorescence cystoscopy, and the specificity of narrow band imaging for early diagnosis of carcinoma in situ. This suggests the potential of narrow band imaging guided 3-dimensional optical coherence tomography for future clinical detection of carcinoma in situ when effective image guidance is desirable.

Combination of narrow band imaging (NBI) and autofluorescence imaging (AFI) videobronchoscopy in endoscopic assessment of lung cancer extension

Both narrow band imaging (NBI) and autofluorescence imaging (AFI) are new techniques for the assessment of lung cancer. The major aim of this study was to investigate whether the combination of these two techniques improve sensitivity and specificity in the assessment of lung cancer extension. The study prospectively evaluated 118 patients with suspected lung cancer. All of the patients were examined using EVIS LUCERA SPECTRUM videobronchoscopy system. The narrow band imaging preceded autofluorescence imaging examination. In every patient, at least 1 but no more than 4 biopsies were taken from places visualized as pathologic, surrounding primary tumor, and at least 1 biopsy from places that appeared visually normal. Sensitivity, specificity, positive, and negative predictive value for autofluorescence imaging in the assessment of tumor extension were 89.2, 77.8, 87, and 81%, respectively. Sensitivity, specificity, positive, and negative predictive value for narrow band imaging were 90.4, 82.4, 91.8, and 79.7%, respectively. Corresponding values for combination of techniques were 93.7, 86.9, 94.5, and 85.1%. Combination of techniques significantly improves sensitivity (P = 0.034) with borderline effect on specificity (P = 0.056) of autofluorescence imaging. There was no significant improvement for sensitivity and specificity of NBI alone. The combination of techniques shows significantly better sensitivity and specificity in the assessment of lung cancer extension when compared to white light videobronchoscopy alone, but improvement is not so convincing when compared to the each technique alone.

Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging

To investigate the characteristics of the laryngeal mucosal microvascular network in suspected laryngeal cancer patients, using narrow band imaging, and to evaluate the value of narrow band imaging endoscopy in the early diagnosis of laryngeal precancerous and cancerous lesions. Eighty-five consecutive patients with suspected precancerous or cancerous laryngeal lesions were enrolled in the study. Endoscopic narrow band imaging findings were classified into five types (I to V) according to the features of the mucosal intraepithelial papillary capillary loops assessed. A total of 104 lesions (45 malignancies and 59 nonmalignancies) was detected under white light and narrow band imaging modes. The sensitivity and specificity of narrow band imaging in detecting malignant lesions were 88.9 and 93.2 per cent, respectively. The intraepithelial papillary capillary loop classification, as determined by narrow band imaging, was closely associated with the laryngeal lesions' histological findings. Type I to IV lesions were considered nonmalignant and type V lesions malignant. For type Va lesions, the sensitivity and specificity of narrow band imaging in detecting severe dysplasia or carcinoma in situ were 100 and 79.5 per cent, respectively. In patients with type Vb and Vc lesions, the sensitivity and specificity of narrow band imaging in detecting invasive carcinoma were 83.8 and 100 per cent, respectively. Narrow band imaging is a promising approach enabling in vivo differentiation of nonmalignant from malignant laryngeal lesions by evaluating the morphology of mucosal capillaries. These results suggest endoscopic narrow band imaging may be useful in the early detection of laryngeal cancer and precancerous lesions.

Can virtual chromoendoscopy measure up to histology in early gastric cancer?

The prognosis of differentiated early gastric cancer is better han that of undifferentiated early gastric cancer, anddifferentiated arly gastric cancer can be removed from the stomach using endocopic submucosal dissection (ESD), regardless of the size of the esion, as long as it does not invade the submucosa. A preliminary iagnosis of undifferentiated early gastric cancer, however, results n the patient being referred directly to surgery for a gastrectomy ithout endoscopic dissection. Yao et al. [1] describe and classify the mucosal changes in icrovascular structure (V=vascular pattern) and microsurface tructure (S = surface pattern) visible with magnification and highesolution endoscopy (at least 8 m). Both V and S can be regular, rregular or absent; however, there is evidence that in early gasric cancer, both V and S are irregular and have a well-defined emarcation line. In the past, the combined use of magnification and chromoenoscopy allowed clear definition of the characteristics of gastric ancer tissue. Today, several types of endoscopes are equipped with techiques for enhancement, magnification and virtual staining, llowing them to correctly displaymicrovascular andmicrosurface tructures. (narrow-band imaging and autofluorescence – Olymus, FICE – Fuji and I-Scan – Pentax). Ezoe et al. [2] compared magnifying white light imaging (WLI) nd magnifying narrow-band imaging (NBI) for small, depressed astric lesions and found that the real-timediagnostic accuracy and ensitivity were significantly higher for NBI than for WLI (79% vs. 4%,P= .0001, and70%vs. 33%,P= .0005, respectively). Thediagnosic specificity of NBI (89%) was also higher than that of WLI (67%), ut this difference was not statistically significant. Nakamura et al. [3] demonstrated the ability to differeniate between adenomas and early gastric cancer in elevated, at lesions of the stomach using magnifying NBI. Notably, in 7% of cases, adenomas showed slight intrastructural irreguar microvascular patterns (ISIMVPs), whereas severe ISIMVPs ere not observed. A fine network pattern of the microvasulature was identified in 3% of cases, but none of the cases howed a corkscrew pattern. Carcinomas showed slight ISIMVPs n 40% of cases, severe ISIMVPs in 15% of cases and a fine netork pattern in 45% of cases, but none of the cases showed a orkscrew pattern. The authors of that study concluded that severe

Narrow-band imaging endoscopy in differential diagnosis of colorectal proliferative lesions

Objective To evaluate the narrow-band imaging （NBI） in differential diagnosis of colorectal proliferative lesions. Methods Suspected lesions in colon were examined with white light and NBI colonoscopy, respectively. The ensitivity and specificity in diagnosing colorectal inflammatory hyperplasia, adenoma, early cancer and advanced cancer were compared between NBI and conventional colonoscopy with reference to pathology as gold standard. The pit patterns and the surface microvessels of the lesions were also determined and scored with NBI combined with magnifying endoscopy, and were compared with pathological diagnosis. Results （ 1 ） A total of 368 lesions were detected in 280 patients with conventional colonoscopy and NBI. The sensitivity and specificity of NBI in differential diagnosis of colorectal lesions were superior to those of conventional colonoscopy. （2） The pit patterns of colorectal inflammatory hyperplasia were mainly type Ⅰ and Ⅱ , while in adenomas were mainly type Ⅱ and Ⅲ （94. 2% ）. The pit patterns of early cancer were type Ⅲ （ 18.8% ）, Ⅳ （56. 3% ） and V （25.0%）, and those of advanced cancer were mainly typeⅤ （94. 0% ）. （ 3 ） The average scores of surface microvessels of colorectal inflammatory hyperplasia, adenoma, early cancer and advanced cancer were 1.35 ± 0. 72, 3.86 ± 1.07, 6. 52 ± 2.59 and 11.42 ± 3.59, respectively. Scores over 6. 5 was a strong indicator of malignant lesions. Conclusion NBI is superior to conventional eolonoseopy in differential diagnosis of colorectal lesions. Observing pit patterns and microves-sels of the lesion with combination of NBI and magnifying endoscopy is helpful in diagnosis. Key words: Colonscopy ; Narrow-band imaging; lntestimal Neoplasms ; Microvessel