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Polyp Detection, Characterization, and Management Using Narrow-Band Imaging
with/without Magnification
#MMPMID26668794
Utsumi T
; Iwatate M
; Sano W
; Sunakawa H
; Hattori S
; Hasuike N
; Sano Y
Clin Endosc
2015[Nov]; 48
(6
): 491-7
PMID26668794
show ga
Narrow-band imaging (NBI) is a new imaging technology that was developed in 2006
and has since spread worldwide. Because of its convenience, NBI has been
replacing the role of chromoendoscopy. Here we review the efficacy of NBI
with/without magnification for detection, characterization, and management of
colorectal polyps, and future perspectives for the technology, including
education. Recent studies have shown that the next-generation NBI system can
detect significantly more colonic polyps than white light imaging, suggesting
that NBI may become the modality of choice from the beginning of screening. The
capillary pattern revealed by NBI, and the NBI International Colorectal
Endoscopic classification are helpful for prediction of histology and for
estimating the depth of invasion of colorectal cancer. However, NBI with
magnifying colonoscopy is not superior to magnifying chromoendoscopy for
estimation of invasion depth. Currently, therefore, chromoendoscopy should also
be performed additionally if deep submucosal invasive cancer is suspected. If
endoscopists become able to accurately estimate colorectal polyp pathology using
NBI, this will allow adenomatous polyps to be resected and discarded; thus,
reducing both the risk of polypectomy and costs. In order to achieve this goal, a
suitable system for education and training in in vivo diagnostics will be
necessary.
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