A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia
Journal
Gut
Journal Volume
56
Journal Issue
3
Pages
373-379
Date Issued
2007
Author(s)
Chang C.-Y.
Lin J.-T.
Abstract
Background: Discrimination between neoplastic and non-neoplastic lesions is crucial in colorectal cancer screening. Application of narrow-band imaging (NBI) in colonoscopy visualises mucosal vascular networks in neoplastic lesions and may improve diagnostic accuracy. Aim: To compare the diagnostic efficacy of NBI in differentiating neoplastic from non-neoplastic colorectal lesions with diagnostic efficacies of standard modalities, conventional colonoscopy, and chromoendoscopy. Methods: In this prospective study, 180 colorectal lesions from 133 patients were observed with conventional colonoscopy, and under low-magnification and high-magnification NBI and chromoendoscopy. Lesions were resected for histopathological analysis. Endoscopic images were stored electronically and randomly allocated to two readers for evaluation. Sensitivity, specificity and diagnostic accuracy of each endoscopic modality were assessed by reference to histopathology. Results: NBI and chromoendoscopy scored better under high magnification than under low magnification in comparison with conventional colonoscopy. The diagnostic accuracy of NBI with low or high magnification was significantly higher than that of conventional colonoscopy (low magnification: p = 0.0434 for reader 1 and p = 0.004 for reader 2; high magnification: p<0.001 for both readers) and was comparable to that of chromoendoscopy. Conclusion: Both low-magnification and high-magnification NBI were capable of distinguishing neoplastic from non-neoplastic colorectal lesions; the diagnostic accuracy of NBI was better than that of conventional colonoscopy and equivalent to that of chromoendoscopy. The role of NBI in screening colonoscopy needs further evaluation.
SDGs
Other Subjects
article; chromoendoscopy; clinical trial; colonoscopy; colorectal tumor; controlled clinical trial; controlled study; diagnostic accuracy; differential diagnosis; female; histopathology; human; human tissue; major clinical study; male; priority journal; sensitivity and specificity; adenoma; adult; aged; colon polyp; comparative study; epidemiology; evaluation; image processing; methodology; middle aged; coloring agent; diagnostic agent; indigo carmine; Adenoma; Adult; Aged; Aged, 80 and over; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Coloring Agents; Diagnosis, Differential; Epidemiologic Methods; Female; Humans; Image Processing, Computer-Assisted; Indigotindisulfonate Sodium; Male; Middle Aged
Type
journal article