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Narrow-band imaging versus white light for the detection of proximal colon serrated lesions: a randomized, controlled
Douglas K Rex1, Ryan Clodfelter1, Farrah Rahmani1
1Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Background:
The value of narrow-band imaging (NBI) for detecting serrated lesions is unknown.
Objective:
To assess NBI for the detection of proximal colon serrated lesions.
Design:
Randomized, controlled trial.
Setting:
Two academic hospital outpatient units.
Patients:
Eight hundred outpatients 50 years of age and older with intact colons undergoing routine screening, surveillance, or diagnostic examinations.
Interventions:
Randomization to colon inspection in NBI versus white-light colonoscopy.
Main Outcome Measurements:
The number of serrated lesions (sessile serrated polyps plus hyperplastic polyps) proximal to the sigmoid colon.
Results:
The mean inspection times for the whole colon and proximal colon were the same for the NBI and white-light groups. There were 204 proximal colon lesions in the NBI group and 158 in the white light group (P = .085). Detection of conventional adenomas was comparable in the 2 groups.
Limitations:
Lack of blinding, endoscopic estimation of polyp location.
Conclusion:
NBI may increase the detection of proximal colon serrated lesions, but the result in this trial did not reach significance. Additional study of this issue is warranted. (
Clinical Trial Registration Number:
NCT01572428.).
