FICE vs Narrow Band Imaging for In Vivo Histologic Diagnosis of Polyps

Gastrointestinal cancers are the most frequently occurring cancers worldwide. Diagnosis and removal of polyps during screening endoscopy decreases the prevalence of colon cancer and cancer-related mortality, and it is considered to be the gold standard in gastrointestinal system cancer prevention. Technological innovations in endoscopy have led to revolutionary developments in many areas. Flexible spectral imaging color enhancement (FICE) and narrow-band imaging (NBI) are forms of digital chromoendoscopy and enhance the endoscopic images without the need for a dye. This study seeks to evaluate the efficacy of FICE and NBI on polyp screening and real-time histologic diagnosis with endoscopy and to compare them.

A total of 134 patients (male/female = 72/62) and 161 polyps were evaluated with FICE or NBI, and real-time histologic diagnosis predictions were classified as neoplastic or nonneoplastic, according to Kudo's pit pattern classification. Pathological results and real-time endoscopic diagnoses were statistically interpreted for both FICE and NBI. Positive predictive value, negative predictive value, sensitivity, specificity, and accuracy rates were calculated and compared for both modalities.

When both systems were compared, the negative predictive value of NBI was found to be higher than that of FICE statistically (P < .001). Specificity and positive predictive value in the FICE group were higher than in the NBI group, but the difference was not statistically significant (P = .082 and P = .153, respectively).

Aside from being safe in polyp detection, digital chromoendoscopy also helps the endoscopist in selecting the type of simultaneous intervention (eg, polypectomy, endomucosal resection, or submucosal dissection) by enabling endoscopic histologic diagnosis.