Evaluation of Narrow-band imaging (NBI) with magnification colonoscopy for improving the diagnostic accuracy of the investigation

B. Vladimirov; I. Terziev; V. Korukov; D. Damyanov; Zh. Cherkezov; Y Nachkov

doi:10.14748/ssm.v43i5.1195

Evaluation of Narrow-band imaging (NBI) with magnification colonoscopy for improving the diagnostic accuracy of the investigation

B. Vladimirov, I. Terziev, V. Korukov, D. Damyanov, Zh. Cherkezov, Y Nachkov

Abstract

In last years many new endoscopic methods, as well as NBI have been introduced with aim to improve the diagnostic accuracy of colonoscopy. The data for their utility to be introduced in the routine clinical practice are not enough yet. The aim of this study was to evaluate the advantages of NBI with magnifying endoscopy compared to conventional colonoscopy for improving the diagnostic accuracy of endoscopic investigation. We analyzed the results of 330 patients with single or multiple (up to 5) colonic lesions found during standard colonoscopy (n=1530), and by magnifying NBI (n=2329Olympus Exera 180). With the use of magnifying endoscopy 799 new lesions were found, mainly benign lesions with size 5 mm (Ã°<0.001). Early cancer or high grade dysplasia was found in 4 new diagnosed lesions (total n=104), and low-grade - in 12 (total n=318). There was a significant correlation between the histological diagnosis and pit pattern of colonic mucosa according to the classification of S. Kudo et al. (Ã°<0.001), as well as the type of microvascular architecture, applying the classification of Y. Sano et al. (Ã° < 0.001). The diagnostic accuracy of NBI magnifying colonoscopy for prediction of the histological changes, evaluating the pit pattern type and type of capillary vessels was 92% and 96% for invasive adenocarcinoma, 95% and 87% - for early cancer or high-grade dysplasia, and between 95 - 100% - for benign lesions, respectively. In conclusion, NBI magnifying endoscopy is a promising method for the diagnosis of small colon lesions, especially for those with size less than 5 mm, and for the differentiation between neoplastic and non-neoplastic colon lesions, as well as the lesions with low-grade and high grade dyplasia or early colorectal carcinoma. In addition, it allows distinction of noninvasive from the invasive cancer.

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DOI: http://dx.doi.org/10.14748/ssm.v43i5.1195

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