NBI was most useful in correctly identifying adenomas

The study appears in the December issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific rosetta stone version 3
journal of the American Society for Gastrointestinal Endoscopy (ASGE).Endoscopy is a procedure that uses an endoscope -- a thin, flexible tube with a light and a lens on the end to look into the esophagus, stomach, duodenum, small intestine, colon, or rectum, in order to diagnose or treat a condition. There are many types of endoscopy, including colonoscopy, sigmoidoscopy, gastroscopy, enteroscopy, and esophogogastroduodenoscopy (EGD). Colonoscopy is frequently used to screen for colorectal cancer, which most typically develops from polyps. The two main polyp types are adenomatous, which are precancerous and hence require removal, and nonadenomatous, which do not have a high likelihood of developing into cancer.Narrow-band imaging is a new optical technology that modifies white light by using only certain wavelengths to enhance the image. The technology provides more visual detail of the lining of the colon (including polyps) and of the small blood vessels near the surface of the polyps. At the present time, there is no widely adopted, easily applied method for distinguishing between adenomatous (potentially pre-cancerous polyps) and nonadenomatous polyps during real-time colonoscopy. From a practical standpoint, the ability to distinguish the two would allow the endoscopist to remove only those polyps with precancerous potential.In this prospective trial, we aimed to compare standard broadband white light colonoscopy with narrow-band imaging for the differentiation of colorectal polyps during real-time colonoscopy by using a modified Kudo pit pattern classification and vascular color intensity grading, said study lead author Jason Rogart, MD, Yale University School of Medicine, New Haven, Conn. Overall, NBI accuracy was 80 percent, compared with 77 percent for white light alone. We also Rosetta Stone Japanese
demonstrated that improved performance can be achieved over time. NBI was most useful in correctly identifying adenomas, polyps that have the most risk of developing into cancer, especially those that are small. The authors went on to state that this is, to their knowledge, the largest study to date that addresses the question of whether NBI outperforms ordinary white light in predicting the histopathologic diagnosis of polyps during real-time colonoscopy.Patients and MethodsA total of 302 patients were enrolled from August 2006 to July 2007 at Yale University; 265 polyps were found in 131 patients resulting in an adenoma detection rate of 30 percent. Of the polyps, 49 percent were adenomas or carcinomas, whereas 51 percent were nonadenomatous; 74 percent of adenomas were 5 mm or smaller, and 42 percent were 3 mm or smaller.Four experienced endoscopists, with a minimum number of 1,000 colonoscopies previously performed (range 1,000-10,000), participated in this study.All colonoscopies were performed with high definition endoscopes.The participating physicians were oriented to NBI before enrollment through a one-hour interactive lecture on NBI, instruction in classifying polyps based on the surface characteristics (simplified Kudo pit pattern and vascular color intensity grading), and a pretest Rosetta Stone Spain Spanish
that consisted of 20 unknown polyps photographed with the NBI system.