Comparison of blue laser imaging and narrow band imaging for the differentiation of diminutive colorectal polyps: A randomized controlled trial
Issued Date
2022-08-01
Resource Type
ISSN
09302794
eISSN
14322218
Scopus ID
2-s2.0-85124772437
Pubmed ID
35182217
Journal Title
Surgical Endoscopy
Volume
36
Issue
8
Start Page
5743
End Page
5752
Rights Holder(s)
SCOPUS
Bibliographic Citation
Surgical Endoscopy Vol.36 No.8 (2022) , 5743-5752
Suggested Citation
Chang A., Munjit P., Sriprayoon T., Pongpaibul A., Prachayakul V. Comparison of blue laser imaging and narrow band imaging for the differentiation of diminutive colorectal polyps: A randomized controlled trial. Surgical Endoscopy Vol.36 No.8 (2022) , 5743-5752. 5752. doi:10.1007/s00464-022-09079-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85699
Title
Comparison of blue laser imaging and narrow band imaging for the differentiation of diminutive colorectal polyps: A randomized controlled trial
Author's Affiliation
Other Contributor(s)
Abstract
Background: To compare the diagnostic efficacy of blue laser imaging (BLI)- bright and narrow band imaging (NBI) modes of image enhanced endoscopy (IEE) in differentiating neoplastic and non-neoplastic lesions of diminutive colorectal polyps. Methods: We conducted a prospective randomized controlled trial from September 2015 to July 2016. The participants were randomly assigned (1:1) for colonoscopy with polyp classification under NBI or BLI-bright mode without magnification. Histopathologic diagnosis was used as the gold standard. Results: Three hundred and twenty-four diminutive polyps in 164 patients were included for analysis (BLI: 162 polyps in 73 patients, NBI: 162 polyps in 91 patients). These polyps were located at colon proximal to sigmoid (61.1 and 58.0%) and rectosigmoid colon (38.9 and 42.0%) in the BLI and NBI groups, respectively. Most polyps (71.9%) were adenomatous with one malignant polyp (0.3%). BLI achieved 86.4% accuracy, 98.3% sensitivity, 55.6% specificity, 85.2% positive predictive value (PPV), and 92.6% negative predictive value (NPV), similar to NBI which exhibited 90.1% accuracy, 99.1% sensitivity, 67.4% specificity, 88.5% PPV, and 96.9% NPV in the diagnosis of adenomatous polyps. Based on the location of the polyp, both modes of IEE provided ≥ 95% NPV for diagnosis of adenomatous polyps at the rectosigmoid colon. Conclusions: BLI-bright and NBI modes of IEE have similar accuracy in differentiation between neoplastic and non-neoplastic lesions of diminutive polyps. Both modes provided ≥ 90% NPV which allows for the adaptation of the American Society of Gastrointestinal Endoscopy “diagnose-and-leave” recommended strategy for diminutive polyps at the rectosigmoid colon.