1. Comparative Study of Conventional Colonoscopy, Chromoendoscopy, and Narrow-Band Imaging Systems in Differential Diagnosis of Neoplastic and Nonneoplastic Colonic Polyps
Ming-Yao Su, M.D., Chen-Ming Hsu, M.D., Yu-Pin Ho, M.D., Pang-Chi Chen, M.D., Chun-Jung Lin, M.D., and Cheng-Tang Chiu, M.D.
Department of Gastroenterology and Hepatology, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
Am J Gastroenterol 2006;101:
R2 In Ah Choi / Prof Jae Young Jang

2. INTRODUCTION colorectal polyp
neoplastic : adenoma, adenocarcinoma
nonneoplastic : hyperplastic, inflammatory, harmatomatous, etc
mucosal biopsy : standard approach for histological diagnosis
chromoendoscopy : ‘ pit pattern analysis’ via magnified colonoscopy and indigo carmine contrast
→ requires considerable time for dye spraying and observations
narrow-band imaging (NBI) system
: light in short and limited wavelengths within the hemoglobin absorption band
→ blood vessels can be demonstrated with adequate contrast for an unobstructed view

3. INTRODUCTION * Objectives
To analyse NBI system for its ability to differentiate between neoplastic and nonneoplastic colorectal polyps
To compared its performance with that of conventional colonoscopy and chromoendoscopy
* Objectives

4. MATERIALS AND METHODS 110 polyps (78 patients) 98 polyps (70 patients)
Chang-Gung Memorial Hospital, Linkou Medical Center,Taiwan,
between January and February 2006
110 polyps (78 patients)
98 polyps (70 patients)
12 polyps (8 patients)
colorectal cancer screening
postpolypectomy follow-up
bowel habit changes
bodyweight loss
due to inadequate colonic preparation
obtaining biopsy specimens was impossible
DVD did not record properly.

5. MATERIALS AND METHODS
Images of each patient’s polyps were recorded on DVD and
blindly reviewed by two experienced colonoscopists
Neoplastic lesions
polyp was found by conventional colonoscopy
reddish discolorization or size more than 10 mm by conventional colonoscopy
change to the NBI system to examine the vascular network
brownish vascular network enhanced by NBI system
0.2% indigo carmine sprayed directly on the mucosa
surface for pit pattern analysis
type III to V pits were found by chromoendoscopy
polypectomized or biopsied for histological analysis

6. RESULTS
Mean

7. RESULTS
Hyperplastic polyp 38
Neoplastic polyp
Malignant change

8. RESULTS
34/33
Neoplastic polyp
33/34
Malignant change 5

9. RESULTS Neoplastic polyp Conventional colonoscopy NBI system
Type IIIL pit pattern by Indigo carmine contrast dye

10. RESULTS Non neoplastic polyp
Type II pit pattern by Indigo carmine contrast dye
Conventional colonoscopy
NBI system

11. RESULTS

12. RESULTS

13. CONCLUSIONS
“ The NBI system identified morphlogic details that correlate well with polyp histology by chromoendoscopy”