Document Detail

Narrow-band versus white-light high definition television endoscopic imaging for screening colonoscopy: a prospective randomized trial.
MedLine Citation:
PMID:  19014944     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Narrow-band imaging (NBI) has been implemented in gastrointestinal endoscopy to improve the contrast of endoluminal pathologic structures, one of the aims being to increase colonic adenoma detection. Previous studies from referral centers have yielded variable and conflicting results with regard to improvement in adenoma detection rates by using NBI. The present large randomized trial was designed to finally settle this issue. METHODS: In a prospective study performed exclusively in a multicenter private practice setting involving 6 examiners with substantial lifetime experience (>10,000 colonoscopies), 1256 patients (men:women, 47%:53%; mean age, 64.4 y) were randomized to HDTV screening colonoscopy with either NBI or white-light imaging on instrument withdrawal. The primary outcome measure was the adenoma detection rate (ie, number of adenomas/total number of patients). RESULTS: There was no difference between the 2 groups in terms of the general adenoma detection rate (0.32 vs 0.34), the total number of adenomas (200 vs 216), or in detection in subgroups of adenomas. This was despite a minimal, but significantly longer, withdrawal time in the NBI group (8.5 vs 7.9 min; P < .05). Only hyperplastic polyps were found more frequently in the NBI group (P = .03). CONCLUSIONS: This large randomized trial in a homogeneous private practice screening setting could not show any objective advantage of the NBI technique over white-light high definition television imaging in terms of improved adenoma detection rate. Contrast enhancement therefore likely will not contribute to a reduction in adenoma miss rates among experienced colonoscopists.
Andreas Adler; Jens Aschenbeck; Timur Yenerim; Michael Mayr; Alireza Aminalai; Rolf Drossel; Andreas Schr?der; Matthias Scheel; Bertram Wiedenmann; Thomas R?sch
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2008-10-15
Journal Detail:
Title:  Gastroenterology     Volume:  136     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-03-02     Revised Date:  2010-04-08    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  410-6.e1; quiz 715     Citation Subset:  AIM; IM    
Central Interdisciplinary Endoscopy Unit, Charit? Medical University Hospitals, Campus Virchow, Berlin, Germany.
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MeSH Terms
Adenoma / diagnosis*,  pathology
Aged, 80 and over
Colonic Neoplasms / diagnosis*,  pathology
Colonoscopy / methods*
Early Detection of Cancer
Middle Aged
Prospective Studies
Television / instrumentation*
Comment In:
Endoscopy. 2010 Jan;42(1):49-52   [PMID:  19856248 ]

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