Impact of narrow-band imaging in screening colonoscopy

Narrow band-imaging (NBI) enhances mucosal visualization of the vascular network and surface structure and helps to increase the visibility of neoplasia by improving contrast. Studies on the detectability of colorectal neoplastic lesions using NBI have primarily been reported in Western countries, but the published opinions and conclusions remain controversial at the present time. Our earlier prospective pilot study demonstrated that NBI colonoscopy significantly improved detection of flat lesions, which are more likely to be missed, particularly on the right side of the colon. It is especially important that even examiners performing routine screening colonoscopies become sufficiently familiar with flat and depressed lesions and then take full advantage of the endoscopic systems and specific image enhancement functions currently available for improved detection of flat and diminutive lesions. Adequate bowel preparation is another important consideration.