Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Conflicting results exist regarding narrow-band imaging (NBI) versus white-light imaging (WLI) for colonic polyp detection.
• A next-generation NBI system was utilized to re-evaluate its efficacy.

Purpose of the Study:

• To compare the colonic polyp detection rate of NBI versus WLI.
• To assess the impact of standard-definition (SD) versus wide-angle (WA) colonoscopy on polyp detection.

Main Methods:

• A 2x2 factorial, prospective, multicenter randomized controlled trial was conducted.
• Patients were assigned to one of four groups: WLI with SD colonoscopy, NBI with SD colonoscopy, WLI with WA colonoscopy, or NBI with WA colonoscopy.
• The mean number of polyps detected per patient was the primary outcome measure.

Main Results:

• A total of 431 patients were enrolled across five academic centers in Japan.
• The mean number of polyps detected per patient was significantly higher with NBI compared to WLI (2.01 vs 1.56; P=0.032).
• Wide-angle (WA) colonoscopy did not yield a significantly higher polyp detection rate compared to standard-definition (SD) colonoscopy (1.97 vs 1.61; P=0.089).

Conclusions:

• Next-generation NBI colonoscopy significantly enhances the detection of colonic polyps.
• Wide-angle colonoscopy did not demonstrate a significant improvement in polyp detection in this trial.