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Endoscopy 2011; 43(10): 862-868
DOI: 10.1055/s-0030-1256510
Original article

© Georg Thieme Verlag KG Stuttgart · New York

The diagnostic accuracy of high-resolution endoscopy, autofluorescence imaging and narrow-band imaging for differentially diagnosing colon adenoma

R.  Sato1 , 2 , M.  Fujiya3 , J.  Watari4 , 5 , N.  Ueno3 , K.  Moriichi3 , S.  Kashima3 , S.  Maeda4 , K.  Ando3 , H.  Kawabata3 , R.  Sugiyama3 , Y.  Nomura3 , T.  Nata3 , K.  Itabashi3 , Y.  Inaba3 , 6 , K.  Okamoto3 , Y.  Mizukami3 , Y.  Saitoh7 , Y.  Kohgo3
  • 1Internal Medicine, Engaru-Kosei General Hospital, Asahikawa, Japan
  • 2Internal Medicine, Kotoni Royal Hospital, Sapporo, Hokkaido, Japan
  • 3Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
  • 4Internal Medicine, Kushiro Medical Association Hospital, Hokkaido, Japan
  • 5Division of Upper Gastroenteroelogy, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
  • 6Martin Boyer Laboratories, University of Chicago, Chicago, Illinois, USA
  • 7Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan
Further Information

Publication History

submitted 2 September 2010

accepted after revision 4 April 2011

Publication Date:
05 July 2011 (online)

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Commentaire de travail de R. Sato et al., pp. 862Endoscopy 2011; 43(10): 223-223
DOI: 10.1055/s-0031-1291766

Background and study aims: Conventional colonoscopy can result in unnecessary biopsy or endoscopic resection due to its inability to distinguish adenomas from hyperplastic polyps. This study therefore evaluated the efficacy of high-resolution endoscopy (HRE), autofluorescence imaging (AFI), and narrow-band imaging (NBI) in discriminating colon adenoma from hyperplastic polyps.

Patients and methods: This was a prospective multicenter study in patients undergoing AFI and NBI examinations. HRE, AFI, and NBI images were classified into two groups based on morphological characteristics, the predominant color intensities, and the visibility of meshed capillary vessels, respectively. Each of the endoscopic photographs were independently evaluated by a single endoscopist. The images were then assessed by three specialists and three residents, the latter having performed < 500 colonoscopies and < 30 NBI and AFI examinations. Diagnostic test statistics were calculated to compare the accuracy in differentiating colon adenoma from hyperplastic polyps for each method.

Results: A total of 183 patients were enrolled in the study and 339 adenomas and 85 hyperplastic polyps were identified. AFI and NBI could distinguish adenoma from hyperplastic polyps with an accuracy of 84.9 % and 88.4 %, respectively, whereas HRE exhibited an accuracy of 75.9 %. In the 358 lesions in which the AFI diagnosis was consistent with that of NBI, the accuracy, sensitivity, and specificity were high, at 91.9 %, 92.7 %, and 92.9 %, respectively. During the study comparing specialists and residents, AFI and NBI dramatically improved the diagnostic accuracy of residents from 69.1 % to 86.1 % and 84.7 %, respectively.

Conclusions: Both AFI and NBI are considered to be feasible tools that can discriminate colon adenoma from hyperplastic polyps, and their use may be particularly beneficial for less-experienced endoscopists.

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M. FujiyaMD, PhD 

Division of Gastroenterology and Hematology/Oncology
Department of Medicine
Asahikawa Medical College

2-1 Midorigaoka-higashi
Asahikawa
Hokkaido 078-8510
Japan

Fax: 81-166-68-2469

Email: fjym@asahikawa-med.ac.jp

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