An Additional 30-s Observation of the Right-Sided Colon with Narrow Band Imaging Decreases Missed Polyps: A Pilot Study



Previous narrow-band imaging (NBI) was dark and reported not to be useful for polyp detection. In this study, we analyzed the efficacy of an additional 30-s observation of the right-sided colon with the recent bright high-resolution NBI.


We enrolled patients undergoing colonoscopy from February 2015 to May 2017 in two institutions. All procedures were performed with the latest system (EVIS LUCERA ELITE, Olympus). The cecum and ascending colon were first observed with white light imaging (WLI) in both the NBI and WLI group. Then, the colonoscope was re-inserted, and the cecum and ascending colon were observed for an additional 30 s. In this second observation, NBI was performed for the first 130 patients in the NBI group and WLI for the next 130 in the WLI group. The number of adenoma and sessile serrated polyps (ASPs) in the second observation were examined in both groups. According to our initial pilot study, the sample size was estimated at 126.


In the first observation, the number of ASPs was 72 in the NBI group and 72 in the WLI group (p = 1.0). In the second observation, the number of ASPs was 23 in the NBI group and 10 in the WLI group (p = 0.02). The polyp and adenoma detection rates in the second observation were 16.2% and 12.3% in the NBI group and 7.7% (p = 0.03) and 6.2% (p = 0.09) in the WLI group.


The additional 30-s observation with recent NBI decreased missed polyps in the right-sided colon.

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We thank all the members of the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, for their assistance with this study.

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Correspondence to Naohisa Yoshida.

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The authors declare no conflict of interest.

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First WLI observation could not detect any polyps. Additional 30-s observation of the right-sided colon with NBI could detect a polyp 3 mm in size in the ascending colon. Histology showed SSP. (MP4 24169 kb)

Video 1

First WLI observation could not detect any polyps. Additional 30-s observation of the right-sided colon with NBI could detect a polyp 3 mm in size in the ascending colon. Histology showed SSP. (MP4 24169 kb)

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Yoshida, N., Inoue, K., Yasuda, R. et al. An Additional 30-s Observation of the Right-Sided Colon with Narrow Band Imaging Decreases Missed Polyps: A Pilot Study. Dig Dis Sci 63, 3457–3464 (2018).

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  • Narrow-band imaging
  • Colorectal polyp
  • Polyp detection
  • Colonoscopy
  • Polyp miss