New-generation narrow band imaging improves visibility of polyps: a colonoscopy video evaluation study

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The benefits of narrow band imaging (NBI) in colorectal polyp detection remain questionable. Previous NBI has poorer brightness and resolution than white light (WL). However, recently these factors were improved by the new-generation video processor system (EVIS LUCERA ELITE) in comparison with the previous system (EVIS LUCERA SPECTRUM). The aim of this study was to investigate whether NBI with EVIS LUCERA ELITE could improve the visibility of colorectal polyps compared to WL.


We analyzed prospectively 240 colorectal polyps (group 1: ELITE with CF-HQ290 scope, 80 polyps; group 2: ELITE with PCF-Q260AZI scope, 80 polyps; group 3: SPECTRUM with PCF-Q260AZI scope, 80 polyps) whose videos were recorded using NBI and WL at Kyoto Prefectural University of Medicine. The videos were evaluated in a randomized order by three experts and three non-experts. Each polyp was assigned a polyp visibility score from 4 (excellent visibility) to 1 (poor visibility). The polyp visibility scores in each mode and their relationship to the clinical characteristics were analyzed.


The mean polyp visibility scores of NBI with ELITE system were significantly higher than those of WL (ELITE with CF-HQ290: 3.14 ± 0.87 vs. 2.75 ± 0.98, p < 0.0001, ELITE with PCF-Q260AZI: 3.03 ± 0.92 vs. 2.83 ± 0.93, p = 0.0006). Conversely, the mean polyp visibility score of NBI using SPECTRUM system with PCF-Q260AZI was significantly lower than WL (2.75 ± 1.06 vs. 3.05 ± 0.92, p < 0.0001).


Our study showed that NBI using EVIS LUCERA ELITE improved polyp visibility.

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  1. 1.

    Joseph DA, King JB, Miller JW, et al. Prevalence of colorectal cancer screening among adults-behavioral risk factor surveillance system, United States, 2010. MMWR Morb Mortal Wkly Rep. 2012;61:51–6.

  2. 2.

    Winawer SJ, Zauber AG, O’Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med. 1993;328:901–6.

  3. 3.

    Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.

  4. 4.

    Levin B, Lieberman DA, Mcfarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134:1570–95.

  5. 5.

    Su MY, Hsu CM, Ho YP, et al. Comparative study of conventional colonoscopy, chromoendoscopy, and narrow-band imaging systems in differential diagnosis of neoplastic and nonneoplastic colonic polyps. Am J Gastroenterol. 2006;101:2711–6.

  6. 6.

    Sano Y, Muto M, Tajiri H, et al. Optical/digital chromoendoscopy during colonoscopy using narrow-band image system. Dig Endosc. 2005;17:S43–8.

  7. 7.

    Uraoka T, Higashi R, Saito Y, et al. Impact of narrow-band imaging in screening colonoscopy. Dig Endosc. 2010;22:S54–6.

  8. 8.

    Yoshida N, Hisabe T, Inada Y, et al. The ability of a novel blue laser imaging system for the diagnosis of invasion depth of colorectal neoplasms. J Gastroenterol. 2014;49:73–80.

  9. 9.

    Inoue T, Murano M, Murano N, et al. Comparative study of conventional colonoscopy and pan-colonic narrow-band imaging system in the detection of neoplastic colonic polyps: a randomized, controlled trial. J Gastroenterol. 2008;43:45–50.

  10. 10.

    Adler A, Aschenbeck J, Yenerim T, et al. Narrow-band versus white-light high definition television endoscopic imaging for screening colonoscopy: a prospective randomized trial. Gastroenterology. 2009;136:410–6.

  11. 11.

    Rastogi A, Early DS, Gupta N, et al. Randomized, controlled trial of standard-definition white-light, high-definition white-light, and narrow-band imaging colonoscopy for the detection of colon polyps and prediction of polyp histology. Gastrointest Endosc. 2011;74:593–602.

  12. 12.

    Ikematsu H, Saito Y, Tanaka S, et al. The impact of narrow band imaging for colon polyp detection: a multicenter randomized controlled trial by tandem colonoscopy. J Gastroenterol. 2012;47:1099–107.

  13. 13.

    Ikematsu H, Matsuda T, Osera S, et al. Usefulness of narrow-band imaging with dual-focus magnification for differential diagnosis of small colorectal polyps. Surg Endosc. 2015;29:844–50.

  14. 14.

    Yoshida N, Hisabe T, Hirose R, et al. Improvement in the visibility of colorectal polyps by using blue laser imaging. Gastrointest Endosc. 2015;82:542–9.

  15. 15.

    Participants in the Paris workshop. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon-November 30 to December 1. 2002. Gastrointest Endosc. 2003;58(Suppl):S3–43.

  16. 16.

    Kanao H, Tanaka S, Oka S, et al. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc. 2009;69:631–6.

  17. 17.

    Horimatsu T, Sano Y, Tanaka S, et al. Next-generation narrow band imaging system for colonic polyp detection: a prospective multicenter randomized trial. Int J Colorectal Dis. 2015;30:947–54.

  18. 18.

    Sano Y, Ikematsu H, Fu KI, et al. Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc. 2009;69:278–83.

  19. 19.

    Ikematsu H, Matsuda T, Emura F, et al. Efficacy of capillary pattern type IIIA/IIIB by magnifying narrow band imaging for estimating depth of invasion of early colorectal neoplasms. BMC Gastroenterology. 2010;10:33.

  20. 20.

    Pasha SF, Leighton JA, Das A, et al. Comparison of the yield and miss rate of narrow band imaging and white light endoscopy in patients undergoing screening or surveillance colonoscopy: a meta-analysis. Am J Gastroenterol. 2012;107:363–70.

  21. 21.

    Dinesen L, Chua TJ, Kaffes AJ. Meta-analysis of narrow-band imaging versus conventional colonoscopy for adenoma detection. Gastrointest Endosc. 2012;75:604–11.

  22. 22.

    Nagorni A, Bjelakovic G, Petrovic B. Narrow band imaging versus conventional white light colonoscopy for the detection of colorectal polyps. Cochrane Database Syst Rev. 2012;1:CD008361.

  23. 23.

    Leung WK, Lo OS, Liu KS, et al. Detection of colorectal adenoma by narrow band imaging (HQ190) vs. high-definition white light colonoscopy: a randomized controlled trial. Am J Gastroenterol. 2014;109:855–63.

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We thank Dr. Nobuaki Yagi and all members of the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, for helping with this study.

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Correspondence to Naohisa Yoshida.

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There are no financial supports or relationships that may pose conflicts of interest in our manuscript. Yuji Naito received scholarship funds for the research from Astellas Pharm Inc., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Eisai Co., Ltd., and Tanabe-Mitsubishi Co., Ltd.

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Ogiso, K., Yoshida, N., Siah, K.T.H. et al. New-generation narrow band imaging improves visibility of polyps: a colonoscopy video evaluation study. J Gastroenterol 51, 883–890 (2016) doi:10.1007/s00535-016-1167-3

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  • Narrow band imaging
  • Colorectal polyp
  • Video
  • Detection