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Randomized Controlled Trial
. 2020 Apr 16;20(1):111.
doi: 10.1186/s12876-020-01257-4.

Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome: a randomized controlled trial with tandem colonoscopy

Fausto Riu Pons  1   2   3 , Montserrat Andreu  4   5   6   7 , Dolores Naranjo  8 , Marco Antonio Álvarez-González  4   5   6 , Agustín Seoane  4   5 , Josep Maria Dedeu  4   5   6 , Luis Barranco  4   5 , Xavier Bessa  4   5   6
Affiliations
Randomized Controlled Trial

Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome: a randomized controlled trial with tandem colonoscopy

Fausto Riu Pons et al. BMC Gastroenterol. .

Abstract

Background: It is unknown whether narrow-band imaging (NBI) could be more effective than high-definition white-light endoscopy (HD-WLE) in detecting serrated lesions in patients with prior serrated lesions > 5 mm not completely fulfilling serrated polyposis syndrome (SPS) criteria.

Methods: We conducted a randomized, cross-over trial in consecutive patients with prior detection of at least one serrated polyp ≥10 mm or ≥ 3 serrated polyps larger than 5 mm, both proximal to the sigmoid colon. Five experienced endoscopists performed same-day tandem colonoscopies, with the order being randomized 1:1 to NBI-HD-WLE or HD-WLE-NBI. All tandem colonoscopies were performed by the same endoscopist.

Results: We included 41 patients. Baseline characteristics were similar in the two cohorts: NBI-HD-WLE (n = 21) and HD-WLE-NBI (n = 20). No differences were observed in the serrated lesion detection rate of NBI versus HD-WLE: 47.4% versus 51.9% (OR 0.84, 95% CI: 0.37-1.91) for the first and second withdrawal, respectively. Equally, no differences were found in the polyp miss rate of NBI versus HD-WLE: 21.3% versus 26.1% (OR 0.77, 95% CI: 0.43-1.38). Follow-up colonoscopy in nine patients (22%) allowed them to be reclassified as having SPS.

Conclusions: In patients with previous serrated lesions, the serrated lesion detection rate was similar with NBI and HD-WLE. A shorter surveillance colonoscopy interval increases the detection of missed serrated polyps and could change the diagnosis of SPS in approximately one in every five patients.

Trial registration: ClinicalTrials.gov NCT02406547, registered on April 2, 2015.

Keywords: Colonic polyps; Colonoscopy; Narrow-band imaging; Optical imaging.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study protocol. Back-to-back colonoscopy study with two randomized groups HD-WLE—NBI and NBI—HD-WLE
Fig. 2
Fig. 2
CONSORT flow chart diagram of study selection
Fig. 3
Fig. 3
Percentage of polyps detected for each group (HD-WLE—NBI and NBI—HD-WLE) and technique distributed by localization and withdrawal. The x-axis shows withdrawals with the two techniques for each anatomical location. The first column shows the first withdrawal with HD-WLE for HD-WLE—NBI group (a) or with NBI for NBI—HD-WLE group (b) and the second column shows the results of the second withdrawal with the opposite. The y-axis shows the polyp detection rate distributed by histology. Abbreviations: HD-WLE: high-definition white light endoscopy; NBI: narrow-band imaging; SSL: sessile serrated lesion; HP: hyperplastic polyp
See this image and copyright information in PMC

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