An Interim Analysis of an Asia-Pacific Multicenter Randomized Study Comparing Colonoscopy Using a New High Definition System in Either White Light or Narrow Band Imaging in the Detection of Adenomas in Subjects Undergoing Screening
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AbstractBackground and Aims: Narrow band imaging (NBI) enhances surface capillaries in colon adenomas and improves their detection. A new generation of high definition (HD) image processor and colonoscopes produce brighter and clearer images in NBI mode and should further improve results. We test the hypothesis that colonoscopy using the new HD system in NBI mode is superior to that in white light (WL) in detecting adenomas in screening subjects. Methods: Average risk subjects (asymptomatic, age > 50, no personal or family history of colon adenoma, cancer or inflammatory bowel disease) were randomized at reaching cecum to undergo examination using either HD NBI or white light. In both groups, lesions were characterized using NBI with a dual focusing (magnification) function and categorized according to Sano's classification. Results: 441 subjects were randomized (NBI, 219, WL, 222). Their mean (SD) age were 57.7 (5.3) and 57.8 (5.1). Examination using NBI was longer (12.4+/-7 vs. 11.1+/-5.6 min, P=0.03). 48.9% and 54.1% of subjects from either group had >1 polyp detected (P=0.28). Polyps per polyp carrier was 2.1 and 2.03 (p=0.47). 144 and 148 adenomas were found in either group. The rate of adenoma detection among subjects was 33.8 and 41% respectively (P=0.9). 14 advanced neoplasms were found in either group (P =0.99). Sensitivity, specificity, PPV and NPV of NBI in diagnosing adenomas were 257/266 (96.6%), 80/99 (80.8%), 257/ 277 (92.8%), 80/89 (89.9%) respectively and those in diagnosing adenomas with high grade dysplasia or carcinoma were 6/7 (85.7%), 244/249 (98%), 6/11 (54.5%) and 244/245 (99.6%) respectively. Conclusions: With a high definition system, NBI and WL are comparable in rate of adenoma detection. NBI is highly sensitive in distinguishing adenomas from non-adenomatous lesions. A comparison between conventional and new NBI systems should be considered.
All Author(s) ListLau JY, Teo EK, Rerknimitr R, Singh R, Bourke MJ, Ng SC
Name of ConferenceDigestive Disease Week (DDW)
Start Date of Conference19/05/2012
End Date of Conference22/05/2012
Place of ConferenceSan Diego
Country/Region of ConferenceUnited States of America
Journal nameDigestive Diease Week
Proceedings TitleGASTROINTESTINAL ENDOSCOPY
Year2012
Month4
Volume Number75
Issue Number4
Pages173 - 173
ISSN0016-5107
LanguagesEnglish-United States

Last updated on 2021-29-11 at 00:39