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Comparison of blue laser imaging and narrow band imaging for the differentiation of diminutive colorectal polyps: A randomized controlled trial

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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.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Hatyai Hospital, Songkhla, Thailand

    Arunchai Chang

  2. Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand

    Parnwad Munjit, Tassanee Sriprayoon & Varayu Prachayakul

  3. Department of Pathology, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Ananya Pongpaibul

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Correspondence to Varayu Prachayakul.

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Arunchai Chang, Parnwad Munjit, Tassanee Sriprayoon, Ananya Pongpaibul, and Varayu Prachayakul declare that they have no conflicts of interest or financial ties to disclose.

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Chang, A., Munjit, P., Sriprayoon, T. et al. Comparison of blue laser imaging and narrow band imaging for the differentiation of diminutive colorectal polyps: A randomized controlled trial. Surg Endosc 36, 5743–5752 (2022). https://doi.org/10.1007/s00464-022-09079-z

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  • DOI: https://doi.org/10.1007/s00464-022-09079-z

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