Use of narrow band imaging in a group endoscopy practice

Narrowband imaging (NBI) is an enhanced endoscopic optical technique which filters white light and accentuates imaging of the mucosal vasculature. Potential clinical applications of NBI include endoscopic inspection of Barrett's esophagus and endoscopic diagnosis of colorectal polyps. The degree to which NBI use has been adopted into clinical practice is unknown. The study objective was to identify the rate of NBI use in patients undergoing elective esophagoduodenoscopy (EGD) and colonoscopy, and to identify procedural factors associated with NBI use.

Elective endoscopic procedures were prospectively observed over a 2-week study period. NBI use during diagnostic EGD or colonoscopy was recorded in blinded fashion.

NBI use was observed in 6.6 % (21/318) of procedures, including 4.7 % (5/106) of EGDs and 7.5 % (16/212) of colonoscopies. There was no difference in rate of NBI use when comparing EGD with or without biopsy, or when comparing colonoscopy with or without biopsy. NBI use was significantly higher in colonoscopy with polypectomy compared with colonoscopy without polypectomy (13 % [10/77] vs. 4.4 % [6/135], P = 0.03). NBI use varied significantly among endoscopists. There was no association between patient type (outpatient vs. inpatient), procedure start time, sedation type, or trainee involvement and use/non-use of NBI. Procedural documentation of NBI use was limited. Conclusions NBI use was observed in 6.6 % of elective endoscopic procedures and was highest in colonoscopies with polypectomy. Rate of NBI use varied significantly among endoscopists. Additional studies are needed to assess the magnitude of impact of NBI on routine endoscopic practice.