Proposal of a new 'resect and discard' strategy using magnifying narrow band imaging: pilot study of diagnostic accuracy

Yoji Takeuchi, Masao Hanafusa, Hiromitsu Kanzaki, Takashi Ohta, Noboru Hanaoka

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND AND AIM: A 'resect and discard' strategy using non-magnifying narrow band imaging (N-NBI) has been proposed for reducing screening colonoscopy costs, but it does not take into consideration advanced histology and magnifying NBI (M-NBI) that can potentially further improve the 'resect and discard' strategy. We conducted a pilot study to investigate the feasibility of M-NBI for the new 'resect and discard' strategy with consideration for advanced histology.

METHODS: The present study involved 63 patients. For each polyp, optical diagnosis was independently made using N-NBI and M-NBI, a decision (discard or send for pathology) was made based on the M-NBI findings, and histological and optical diagnosis results were compared.

RESULTS: Sensitivity, specificity and accuracy (95% confidence interval) of M-NBI for lesions with advanced histology were 1.00 (0.36-1.00), 0.92 (0.91-0.92) and 0.92 (0.90-0.92), respectively. Whereas the management of 86% of small polyps could be decided without formal histopathology, lesions with advanced histology were not discarded using M-NBI. The diagnostic accuracy of M-NBI in distinguishing neoplastic from non-neoplastic lesions was higher than that of N-NBI.

CONCLUSIONS: We propose a new resect and discard strategy with advanced histology using M-NBI that is a promising strategy to reduce the costs of histopathology and to minimize the risk of discarding important lesions.

Original languageEnglish
Pages (from-to)90-97
Number of pages8
JournalDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
Volume26
DOIs
Publication statusPublished - Apr 1 2014
Externally publishedYes

Keywords

  • colon polyp surveillance
  • colonoscopy
  • colorectal neoplasm
  • narrow band imaging
  • resect and discard

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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