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Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps.
Surg Endosc. 2015 Apr; 29(4):844-50.SE

Abstract

BACKGROUND

Many authors have already reported the usefulness of narrow-band imaging (NBI) for the differential diagnosis of non-neoplastic and neoplastic colorectal lesions. However, it is not clear whether magnification is required for differential diagnosis. The aim of this prospective study was to clarify the clinical usefulness of a newly developed NBI system with a dual focus function (dual-focus NBI) compared with conventional white-light imaging (WLI) and NBI without magnification for distinguishing between non-neoplastic and neoplastic lesions.

PATIENTS AND METHODS

Thirty-seven consecutive patients who underwent screening colonoscopy with the novel system between July and December 2013 were analyzed. Patients with polyps >10 mm and those with polyps previously evaluated by histologic examination or colonoscopy were excluded. Lesions were diagnosed in real time with WLI, NBI without magnification, and dual-focus NBI, and then excised endoscopically. Each diagnosis was compared to that in the final histopathology reports. The primary endpoint was the diagnostic accuracy and the confidence level assigned to each modality by the endoscopists. The secondary endpoint was the differentiation ability according to the size of the lesion (≤5 and 6-10 mm).

RESULTS

In all, 100 lesions including 76 adenomatous polyps and 24 hyperplastic polyps were analyzed in 37 patients. The overall diagnostic accuracy, sensitivity, and specificity for differentiating adenomatous from hyperplastic polyps were 87.0, 89.5, and 79.2 % for WLI, 93.0, 94.7, and 87.5 % for NBI without magnification, and 94.0, 96.1, and 87.5 % for dual-focus NBI, respectively. The level of confidence was significantly different between dual-focus NBI and WLI and NBI without magnification for diminutive (≤5 mm) lesions (p < 0.001 and p < 0.01).

CONCLUSION

Dual-focus NBI is especially useful for differential diagnosis of diminutive colorectal lesions.

Authors+Show Affiliations

Department of Gastrointestinal Oncology & Endoscopy, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba, 277-8577, Japan, hikemats@east.ncc.go.jp.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

25106719

Citation

Ikematsu, Hiroaki, et al. "Usefulness of Narrow-band Imaging With Dual-focus Magnification for Differential Diagnosis of Small Colorectal Polyps." Surgical Endoscopy, vol. 29, no. 4, 2015, pp. 844-50.
Ikematsu H, Matsuda T, Osera S, et al. Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps. Surg Endosc. 2015;29(4):844-50.
Ikematsu, H., Matsuda, T., Osera, S., Imajoh, M., Kadota, T., Morimoto, H., Sakamoto, T., Oono, Y., Kaneko, K., & Saito, Y. (2015). Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps. Surgical Endoscopy, 29(4), 844-50. https://doi.org/10.1007/s00464-014-3736-y
Ikematsu H, et al. Usefulness of Narrow-band Imaging With Dual-focus Magnification for Differential Diagnosis of Small Colorectal Polyps. Surg Endosc. 2015;29(4):844-50. PubMed PMID: 25106719.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps. AU - Ikematsu,Hiroaki, AU - Matsuda,Takahisa, AU - Osera,Shozo, AU - Imajoh,Maomi, AU - Kadota,Tomohiro, AU - Morimoto,Hiroyuki, AU - Sakamoto,Taku, AU - Oono,Yasuhiro, AU - Kaneko,Kazuhiro, AU - Saito,Yutaka, Y1 - 2014/08/09/ PY - 2014/02/19/received PY - 2014/07/08/accepted PY - 2014/8/10/entrez PY - 2014/8/12/pubmed PY - 2015/9/4/medline SP - 844 EP - 50 JF - Surgical endoscopy JO - Surg Endosc VL - 29 IS - 4 N2 - BACKGROUND: Many authors have already reported the usefulness of narrow-band imaging (NBI) for the differential diagnosis of non-neoplastic and neoplastic colorectal lesions. However, it is not clear whether magnification is required for differential diagnosis. The aim of this prospective study was to clarify the clinical usefulness of a newly developed NBI system with a dual focus function (dual-focus NBI) compared with conventional white-light imaging (WLI) and NBI without magnification for distinguishing between non-neoplastic and neoplastic lesions. PATIENTS AND METHODS: Thirty-seven consecutive patients who underwent screening colonoscopy with the novel system between July and December 2013 were analyzed. Patients with polyps >10 mm and those with polyps previously evaluated by histologic examination or colonoscopy were excluded. Lesions were diagnosed in real time with WLI, NBI without magnification, and dual-focus NBI, and then excised endoscopically. Each diagnosis was compared to that in the final histopathology reports. The primary endpoint was the diagnostic accuracy and the confidence level assigned to each modality by the endoscopists. The secondary endpoint was the differentiation ability according to the size of the lesion (≤5 and 6-10 mm). RESULTS: In all, 100 lesions including 76 adenomatous polyps and 24 hyperplastic polyps were analyzed in 37 patients. The overall diagnostic accuracy, sensitivity, and specificity for differentiating adenomatous from hyperplastic polyps were 87.0, 89.5, and 79.2 % for WLI, 93.0, 94.7, and 87.5 % for NBI without magnification, and 94.0, 96.1, and 87.5 % for dual-focus NBI, respectively. The level of confidence was significantly different between dual-focus NBI and WLI and NBI without magnification for diminutive (≤5 mm) lesions (p < 0.001 and p < 0.01). CONCLUSION: Dual-focus NBI is especially useful for differential diagnosis of diminutive colorectal lesions. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/25106719/Usefulness_of_narrow_band_imaging_with_dual_focus_magnification_for_differential_diagnosis_of_small_colorectal_polyps_ L2 - https://doi.org/10.1007/s00464-014-3736-y DB - PRIME DP - Unbound Medicine ER -