Narrow-band imaging as an alternative to chromoendoscopy for the detection of dysplasia in long-standing inflammatory bowel disease: a prospective, randomized, crossover study

Background Narrow-band imaging (NBI) is a novel technique that may represent an alternative method to chromoendoscopy (CE) for the detection of colitis-associated intraepithelial neoplasia (IN) in patients with long-standing inflammatory bowel disease (IBD). Objective To compare NBI with CE for the...

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Bibliographic Details
Published in:Gastrointestinal endoscopy 2011-10, Vol.74 (4), p.840-848
Main Authors: Pellisé, Maria, MD, PhD, López-Cerón, Maria, MD, Rodríguez de Miguel, Cristina, RN, Jimeno, Mireya, MD, Zabalza, Michel, MD, Ricart, Elena, MD, PhD, Aceituno, Montserrat, MD, Fernández-Esparrach, Glòria, MD, PhD, Ginès, Angels, MD, PhD, Sendino, Oriol, MD, Cuatrecasas, Miriam, MD, PhD, Llach, Josep, MD, PhD, Panés, Julián, MD, PhD
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biopsy
Carcinoma in Situ - diagnosis
Carcinoma in Situ - pathology
Colonic Neoplasms - diagnosis
Colonic Neoplasms - pathology
Colonoscopes
Colonoscopy - methods
Coloring Agents
Cross-Over Studies
Digestive system. Abdomen
Endoscopy
Female
Gastroenterology and Hepatology
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Image Enhancement
Indigo Carmine
Inflammatory Bowel Diseases - complications
Inflammatory Bowel Diseases - pathology
Intestinal Mucosa - pathology
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Precancerous Conditions - diagnosis
Precancerous Conditions - pathology
Sensitivity and Specificity
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Description
Summary:Background Narrow-band imaging (NBI) is a novel technique that may represent an alternative method to chromoendoscopy (CE) for the detection of colitis-associated intraepithelial neoplasia (IN) in patients with long-standing inflammatory bowel disease (IBD). Objective To compare NBI with CE for the detection of IN. Design Prospective, randomized, crossover study. Setting Academic hospital. Patients Patients with clinically inactive colonic IBD (≥8 years). Intervention Patients underwent both CE and NBI in randomized order. Targeted biopsy specimens from abnormal areas were obtained. Pathological examination was regarded as the reference standard. Main Outcome Measurements Number of false-positive and true-positive lesions in patients undergoing CE and NBI were compared as well as the proportion of patients with missed IN lesions. Results Eighty patients were screened, of whom 20 were excluded. Mean ± standard deviation withdrawal time for CE was significantly longer than that for NBI (26.87 ± 9.89 minutes vs 15.74 ± 5.62 minutes, P < .01). Thirteen patients had at least 1 IN lesion on 1 of the examinations. In the per-lesion analysis, NBI resulted in a significantly inferior false-positive biopsy rate ( P = .001) and a similar true-positive rate. The percentage of missed IN lesions and patients was superior with NBI, albeit without reaching statistical significance. Limitations Lesions were sampled immediately after detection, which precluded the possibility of paired analysis. Conclusions NBI appears to be a less time-consuming and equally effective alternative to CE for the detection of IN. However, given the NBI lesion and patient miss rates, it cannot be recommended as the standard technique.
ISSN:0016-5107
1097-6779
DOI:10.1016/j.gie.2011.05.013