Endosc Int Open 2015; 03(02): E140-E145
DOI: 10.1055/s-0034-1391362
Original article
© Georg Thieme Verlag KG Stuttgart · New York

The addition of high magnifying endoscopy improves rates of high confidence optical diagnosis of colorectal polyps

Mineo Iwatate
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Yasushi Sano
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Santa Hattori
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Wataru Sano
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Noriaki Hasuike
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Taro Ikumoto
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Masahito Kotaka
1   Sano Hospital, Gastrointestinal Center, Kobe, Japan
,
Yoshitaka Murakami
2   Department of Medical Statistics, Toho University, Tokyo, Japan
,
David G. Hewett
3   University of Queensland School of Medicine, Brisbane, Australia
,
Roy Soetikno
4   Gastroenterology, Stanford University School of Medicine, Palo Alto, California, USA
,
Tonya Kaltenbach
4   Gastroenterology, Stanford University School of Medicine, Palo Alto, California, USA
,
Takahiro Fujimori
5   Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Tochigi, Japan
› Author Affiliations
Further Information

Publication History

submitted 09 July 2014

accepted after revision 05 December 2014

Publication Date:
17 February 2015 (online)

Zoom Image

Background and study aims: The real-time optical diagnosis of colorectal polyps with high confidence predictions can achieve high levels of accuracy. Increasing the rates of high confidence optical diagnosis can improve the clinical application of real-time optical diagnosis in routine practice. The primary aim of this prospective study was to evaluate whether high magnifying endoscopy improves the rates of high confidence narrow-band imaging (NBI) – based optical diagnosis for differentiating between neoplastic and non-neoplastic colorectal lesions according to the NBI international colorectal endoscopic (NICE) classification.

Patients and methods: Consecutive adult patients undergoing colonoscopy with a high magnifying (maximum, × 80) colonoscope between April and August 2012 were recruited. The optical diagnosis for each polyp was evaluated during colonoscopy in two consecutive stages by the same endoscopist, who first used NBI with non-magnifying endoscopy (NBI-NME), then NBI with magnifying endoscopy (NBI-ME). A level of confidence was assigned to each prediction.

Results: The analysis included 124 patients (mean age, 56.4 years; male-to-female ratio, 72:52) with 248 polyps smaller than 10 mm. Of the 248 polyps, 210 were 1 to 5 mm in size and 38 were 6 to 9 mm in size; 77 polyps were hyperplastic, 4 were sessile serrated adenomas/polyps, 160 were low grade adenomas, 5 were high grade adenomas, and 2 were deep submucosal invasive carcinomas. The rate of high confidence optical diagnosis when NBI-ME was used was significantly higher than the rate when NBI-NME was used for diminutive (1 – 5 mm) polyps (92.9 % vs 79.5 %, P < 0.001) and for small (6 – 9 mm) polyps (94.7 % vs 84.2 %, P = 0.048).

Conclusion: High magnifying endoscopy significantly improved the rates of high confidence NBI-based optical diagnosis of diminutive and small colorectal polyps.

Study registration: UMIN 000007608