Narrow-band imaging has been implemented in gastrointestinal endoscopy to improve the contrast of endoluminal pathologic structures, one of the aims being to increase colonic adenoma detection.
Previous studies from referral centers have yielded variable and conflicting results with regard to improvement in adenoma detection rates by using narrow-band imaging.
Dr Andreas Adler and colleagues conducted a prospective study performed exclusively in a multicenter private practice setting involving 6 examiners with substantial lifetime experience.
The research team evaluated 1256 patients randomized to high definition television screening colonoscopy with either narrow-band imaging or white-light imaging on instrument withdrawal.
The primary outcome measure was the adenoma detection rate
|Hyperplastic polyps were more frequent in the narrow-band imagaing|
There was no difference between the 2 groups in terms of the general adenoma detection rate, the total number of adenomas, or in detection in subgroups of adenomas.
The difference between the groups persisted despite a minimal, but significantly longer, withdrawal time in the narrow-band imaging group.
The team found that hyperplastic polyps were more frequent in the narrow-band imagaing group.
Dr Adler’s team commented, “This large randomized trial in a homogeneous private practice screening setting could not show any objective advantage of the narrow-band imaging technique over white-light high definition television imaging in terms of improved adenoma detection rate.”
“Contrast enhancement therefore likely will not contribute to a reduction in adenoma miss rates among experienced colonoscopists.”