RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0033-1359256
Use of narrow band imaging in a group endoscopy practice
Publikationsverlauf
received: 06. November 2013
accepted after revision: 09. Dezember 2013
Publikationsdatum:
19. Dezember 2013 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00025476/201301/lookinside/thumbnails/10.1055-s-0033-1359256-1.jpg)
Background and study aim: 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.
Methods: Elective endoscopic procedures were prospectively observed over a 2-week study period. NBI use during diagnostic EGD or colonoscopy was recorded in blinded fashion.
Results: 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.
-
References
- 1 Gono K, Obi T, Yamaguchi M et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 2004; 9: 568-577 PubMed
- 2 Mannath J, Subramanian V, Hawkey CJ et al. Narrow band imaging for characterization of high grade dysplasia and specialized intestinal metaplasia in Barrett’s esophagus: a meta-analysis. Endoscopy 2010; 42: 351-359 PubMed
- 3 Wolfsen HC, Crook JE, Krishna M et al. Prospective, controlled tandem endoscopy study of narrow band imaging for dysplasia detection in Barrett’s Esophagus. Gastroenterology 2008; 135: 24-31 PubMed
- 4 Hewett DG, Kaltenbach T, Sano Y et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143: 599-607 e1 PubMed
- 5 Nagorni A, Bjelakovic G, Petrovic B. Narrow band imaging versus conventional white light colonoscopy for the detection of colorectal polyps. Cochrane Database Syst Rev 2012; 1 CD008361 10.1002/14651858. CD008361. pub2 PubMed
- 6 Pasha SF, Leighton JA, Das A et al. Comparison of the yield and miss rate of narrow band imaging and white light endoscopy in patients undergoing screening or surveillance colonoscopy: a meta-analysis. Am J Gastroenterol 2012; 107: 363-370 PubMed quiz 371
- 7 Rastogi A, Early DS, Gupta N et al. Randomized, controlled trial of standard-definition white-light, high-definition white-light, and narrow-band imaging colonoscopy for the detection of colon polyps and prediction of polyp histology. Gastrointest Endosc 2011; 74: 593-602 PubMed
- 8 Cash BD. Narrow-band imaging for colorectal polyps: it can be taught but will it be used?. Gastrointest Endosc 2010; 72: 577-579 PubMed
- 9 Heuberger D, Manner H, Ell C et al. How is early Barrett’s cancer currently diagnosed and treated in Western Europe? Results of a survey at 52 university hospitals in eight Western European countries. Z Gastroenterol 2012; 50: 670-676 PubMed
- 10 Spechler SJ, Sharma P, Souza RF et al. American Gastroenterological Association medical position statement on the management of Barrett’s esophagus. Gastroenterology 2011; 140: 1084-1091 PubMed
- 11 Dai J, Shen YF, Sano Y et al. Evaluation of narrow-band imaging in the diagnosis of colorectal lesions: is a learning curve involved?. Dig Endosc 2013; 25: 180-188 PubMed
- 12 Patel SG, Rastogi A, Austin G et al. Gastroenterology trainees can easily learn histologic characterization of diminutive colorectal polyps with narrow band imaging. Clin Gastroenterol Hepatol 2013; 11: 997-1003 e1 PubMed
- 13 Rex DK, Kahi C, O’Brien M et al. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc 2011; 73: 419-422 PubMed