Clin Colon Rectal Surg 2010; 23(1): 021-030
DOI: 10.1055/s-0030-1247853
© Thieme Medical Publishers

Current Status of Chromoendoscopy and Narrow Band Imaging in Colonoscopy

Jonathan P. Nass1 , Sean E. Connolly1
  • 1Department of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
09. März 2010 (online)

ABSTRACT

Colonoscopy, the preferred procedure for colon cancer screening, has well-documented limitations. To improve colonoscopy's effectiveness, augmented endoscopy techniques, such as chromoendoscopy and narrow band imaging (NBI) have been evaluated. Both techniques are inexpensive, safe, and relatively easy to perform. Chromoendoscopy has an increasingly important role in surveillance of IBD, but significant work is needed to determine the optimal staining techniques and mucosal surface pattern analysis before this technique can be incorporated into routine clinical practice. NBI is a much newer technology with far less data. Well-designed prospective randomized controlled trials have failed to identify a benefit of NBI in screening colonoscopy, in surveillance for high-risk populations or as an adjunct for therapeutic procedures.

REFERENCES

  • 1 Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun M J. Cancer statistics, 2009.  CA Cancer J Clin. 2009;  59(4) 225-249
  • 2 Winawer S J, Zauber A G, Ho M N The National Polyp Study Workgroup et al. Prevention of colorectal cancer by colonoscopic polypectomy.  N Engl J Med. 1993;  329(27) 1977-1981
  • 3 Rex D K, Johnson D A, Anderson J C, Schoenfeld P S, Burke C A, Inadomi J M. American College of Gastroenterology . American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected].  Am J Gastroenterol. 2009;  104(3) 739-750 , Erratum in: Am J Gastroenterol 2009;104:1613
  • 4 Chen S C, Rex D K. Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy.  Am J Gastroenterol. 2007;  102(4) 856-861
  • 5 Barclay R L, Vicari J J, Doughty A S, Johanson J F, Greenlaw R L. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.  N Engl J Med. 2006;  355(24) 2533-2541
  • 6 Chen S C, Rex D K. Variable detection of nonadenomatous polyps by individual endoscopists at colonoscopy and correlation with adenoma detection.  J Clin Gastroenterol. 2008;  42(6) 704-707
  • 7 Imperiale T F, Glowinski E A, Juliar B E, Azzouz F, Ransohoff D F. Variation in polyp detection rates at screening colonoscopy.  Gastrointest Endosc. 2009;  69(7) 1288-1295
  • 8 Benson M E, Reichelderfer M, Said A, Gaumnitz E A, Pfau P R. Variation in colonoscopic technique and adenoma detection rates at an academic gastroenterology unit.  Dig Dis Sci. 2010;  55(1) 166-171
  • 9 Rex D K, Cutler C S, Lemmel G T et al.. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies.  Gastroenterology. 1997;  112(1) 24-28
  • 10 Heresbach D, Barrioz T, Lapalus M G et al.. Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies.  Endoscopy. 2008;  40(4) 284-290
  • 11 van Rijn J C, Reitsma J B, Stoker J, Bossuyt P M, van Deventer S J, Dekker E. Polyp miss rate determined by tandem colonoscopy: a systematic review.  Am J Gastroenterol. 2006;  101(2) 343-350
  • 12 Stoffel E M, Turgeon D K, Stockwell D H Great Lakes-New England Clinical Epidemiology and Validation Center of the Early Detection Research Network. et al. Missed adenomas during colonoscopic surveillance in individuals with Lynch syndrome (hereditary nonpolyposis colorectal cancer).  Cancer Prev Res. 2008;  1(6) 470-475
  • 13 Bressler B, Paszat L F, Vinden C, Li C, He J, Rabeneck L. Colonoscopic miss rates for right-sided colon cancer: a population-based analysis.  Gastroenterology. 2004;  127(2) 452-456
  • 14 Johnson C D, Chen M H, Toledano A Y et al.. Accuracy of CT colonography for detection of large adenomas and cancers.  N Engl J Med. 2008;  359(12) 1207-1217 , Erratum in: N Engl J Med 2008;359:2853
  • 15 Pickhardt P J, Choi J R, Hwang I et al.. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults.  N Engl J Med. 2003;  349(23) 2191-2200
  • 16 Barclay R L, Vicari J J, Doughty A S, Johanson J F, Greenlaw R L. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy.  N Engl J Med. 2006;  355(24) 2533-2541
  • 17 Simmons D T, Harewood G C, Baron T H et al.. Impact of endoscopist withdrawal speed on polyp yield: implications for optimal colonoscopy withdrawal time.  Aliment Pharmacol Ther. 2006;  24(6) 965-971
  • 18 Barclay R L, Vicari J J, Greenlaw R L. Effect of a time-dependent colonoscopic withdrawal protocol on adenoma detection during screening colonoscopy.  Clin Gastroenterol Hepatol. 2008;  6(10) 1091-1098
  • 19 Abdul-Baki H, Hashash J G, Elhajj I I et al.. A randomized, controlled, double-blind trial of the adjunct use of tegaserod in whole-dose or split-dose polyethylene glycol electrolyte solution for colonoscopy preparation.  Gastrointest Endosc. 2008;  68(2) 294-300, quiz 334, 336
  • 20 Park J S, Sohn C I, Hwang S J et al.. Quality and effect of single dose versus split dose of polyethylene glycol bowel preparation for early-morning colonoscopy.  Endoscopy. 2007;  39(7) 616-619
  • 21 Aoun E, Abdul-Baki H, Azar C et al.. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation.  Gastrointest Endosc. 2005;  62(2) 213-218
  • 22 El Sayed A M, Kanafani Z A, Mourad F H et al.. A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation.  Gastrointest Endosc. 2003;  58(1) 36-40
  • 23 East J E, Stavrindis M, Thomas-Gibson S, Guenther T, Tekkis P P, Saunders B P. A comparative study of standard vs. high definition colonoscopy for adenoma and hyperplastic polyp detection with optimized withdrawal technique.  Aliment Pharmacol Ther. 2008;  28(6) 768-776
  • 24 Rex D K, Chadalawada V, Helper D J. Wide angle colonoscopy with a prototype instrument: impact on miss rates and efficiency as determined by back-to-back colonoscopies.  Am J Gastroenterol. 2003;  98(9) 2000-2005
  • 25 Sanaka M R, Deepinder F, Thota P N, Lopez R, Burke C A. Adenomas are detected more often in morning than in afternoon colonoscopy.  Am J Gastroenterol. 2009;  104(7) 1659-1664, quiz 1665
  • 26 Chan M Y, Cohen H, Spiegel B M. Fewer polyps detected by colonoscopy as the day progresses at a Veteran's Administration teaching hospital.  Clin Gastroenterol Hepatol. 2009;  7(11) 1217-1223, quiz 1143
  • 27 Gorgun E, Church J. Flat adenomas of the large bowel: a single endoscopist study.  Dis Colon Rectum. 2009;  52(5) 972-977
  • 28 Soetikno R M, Kaltenbach T, Rouse R V et al.. Prevalence of nonpolypoid (flat and depressed) colorectal neoplasms in asymptomatic and symptomatic adults.  JAMA. 2008;  299(9) 1027-1035
  • 29 Kawai K, Ida K, Kohli Y. On the dye scattering method for endoscopy, new field in gastrointestinal endoscopy. In: Maratka Z, Setka J Urgent Endoscopy of Digestive and Abdominal Diseases. International Symposium of International Society of Gastrointestinal Endoscopy: Society of Gastroenterology and Nutrition 1971 Prague and Carlsbad; Karger 1971
  • 30 Ida K, Kohli K, Shimamoto Y, Hashimoto Y, Kawai K. Endoscopical findings of fundic and pyloric gland area using dye scattering method.  Endoscopy. 1973;  5 21-26
  • 31 Tada M, Katoh S, Kohli Y, Kawai K. On the dye spraying method in colonofiberscopy.  Endoscopy. 1977;  8(2) 70-74
  • 32 Mitooka H, Fujimori T, Ohno S et al.. Chromoscopy of the colon using indigo carmine dye with electrolyte lavage solution.  Gastrointest Endosc. 1992;  38(3) 373-374
  • 33 Dinis-Ribeiro M, da Costa-Pereira A, Lopes C et al.. Magnification chromoendoscopy for the diagnosis of gastric intestinal metaplasia and dysplasia.  Gastrointest Endosc. 2003;  57(4) 498-504
  • 34 Meining A, Rösch T, Kiesslich R, Muders M, Sax F, Heldwein W. Inter- and intra-observer variability of magnification chromoendoscopy for detecting specialized intestinal metaplasia at the gastroesophageal junction.  Endoscopy. 2004;  36(2) 160-164
  • 35 Huang Q, Fukami N, Kashida H et al.. Interobserver and intra-observer consistency in the endoscopic assessment of colonic pit patterns.  Gastrointest Endosc. 2004;  60(4) 520-526
  • 36 Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy.  Gastrointest Endosc. 1996;  44(1) 8-14
  • 37 Kumar S S, Ghosh A, Devasagayam T P, Chauhan P S. Effect of vanillin on methylene blue plus light-induced single-strand breaks in plasmid pBR322 DNA.  Mutat Res. 2000;  469(2) 207-214
  • 38 Epe B, Hegler J, Wild D. Singlet oxygen as an ultimately reactive species in Salmonella typhimurium DNA damage induced by methylene blue/visible light.  Carcinogenesis. 1989;  10(11) 2019-2024
  • 39 Boiteux S, Gajewski E, Laval J, Dizdaroglu M. Substrate specificity of the Escherichia coli Fpg protein (formamidopyrimidine-DNA glycosylase): excision of purine lesions in DNA produced by ionizing radiation or photosensitization.  Biochemistry. 1992;  31(1) 106-110
  • 40 Olliver J R, Wild C P, Sahay P, Dexter S, Hardie L J. Chromoendoscopy with methylene blue and associated DNA damage in Barrett's oesophagus.  Lancet. 2003;  362(9381) 373-374
  • 41 Kiesslich R, Burg J, Kaina B, Galle P R, Neurath M F. Safety and efficacy of methylene blue-aided chromoendoscopy in ulcerative colitis: a prospective pilot study upon previous chromoendoscopies. (abstract).  Gastrointest Endosc. 2004;  59 AB97
  • 42 Dinis-Ribeiro M, Moreira-Dias L. There is no clinical evidence of consequences after methylene blue chromoendoscopy.  Gastrointest Endosc. 2008;  67(7) 1209
  • 43 Davies J, Burke D, Olliver J R, Hardie L J, Wild C P, Routledge M N. Methylene blue but not indigo carmine causes DNA damage to colonocytes in vitro and in vivo at concentrations used in clinical chromoendoscopy.  Gut. 2007;  56(1) 155-156
  • 44 Kiesslich R, von Bergh M, Hahn M, Hermann G, Jung M. Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.  Endoscopy. 2001;  33(12) 1001-1006
  • 45 Brooker J C, Saunders B P, Shah S G et al.. Total colonic dye-spray increases the detection of diminutive adenomas during routine colonoscopy: a randomized controlled trial.  Gastrointest Endosc. 2002;  56(3) 333-338
  • 46 Hurlstone D P, Cross S S, Slater R, Sanders D S, Brown S. Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy.  Gut. 2004;  53(3) 376-380
  • 47 Le Rhun M, Coron E, Parlier D et al.. High resolution colonoscopy with chromoscopy versus standard colonoscopy for the detection of colonic neoplasia: a randomized study.  Clin Gastroenterol Hepatol. 2006;  4(3) 349-354
  • 48 Matsumoto T, Nakamura S, Jo Y, Yao T, Iida M. Chromoscopy might improve diagnostic accuracy in cancer surveillance for ulcerative colitis.  Am J Gastroenterol. 2003;  98(8) 1827-1833
  • 49 Kiesslich R, Fritsch J, Holtmann M et al.. Methylene blue-aided chromoendoscopy for the detection of intraepithelial neoplasia and colon cancer in ulcerative colitis.  Gastroenterology. 2003;  124(4) 880-888
  • 50 Rutter M D, Saunders B P, Schofield G, Forbes A, Price A B, Talbot I C. Pancolonic indigo carmine dye spraying for the detection of dysplasia in ulcerative colitis.  Gut. 2004;  53(2) 256-260
  • 51 Marion J F, Waye J D, Present D H Chromoendoscopy Study Group at Mount Sinai School of Medicine et al. Chromoendoscopy-targeted biopsies are superior to standard colonoscopic surveillance for detecting dysplasia in inflammatory bowel disease patients: a prospective endoscopic trial.  Am J Gastroenterol. 2008;  103(9) 2342-2349
  • 52 Hurlstone D P, Karajeh M, Cross S S et al.. The role of high-magnification-chromoscopic colonoscopy in hereditary nonpolyposis colorectal cancer screening: a prospective “back-to-back” endoscopic study.  Am J Gastroenterol. 2005;  100(10) 2167-2173
  • 53 Itzkowitz S H, Present D H. Crohn's and Colitis Foundation of America Colon Cancer in IBD Study Group . Consensus conference: colorectal cancer screening and surveillance in inflammatory bowel disease.  Inflamm Bowel Dis. 2005;  11(3) 314-321
  • 54 Matsumoto T, Esaki M, Fujisawa R, Nakamura S, Yao T, Iida M. Chromoendoscopy, narrow-band imaging colonoscopy, and autofluorescence colonoscopy for detection of diminutive colorectal neoplasia in familial adenomatous polyposis.  Dis Colon Rectum. 2009;  52(6) 1160-1165
  • 55 Tung S Y, Wu C S, Su M Y. Magnifying colonoscopy in differentiating neoplastic from nonneoplastic colorectal lesions.  Am J Gastroenterol. 2001;  96(9) 2628-2632
  • 56 Eisen G M, Kim C Y, Fleischer D E et al.. High-resolution chromoendoscopy for classifying colonic polyps: a multicenter study.  Gastrointest Endosc. 2002;  55(6) 687-694
  • 57 Hurlstone D P, Cross S S, Adam I et al.. Efficacy of high magnification chromoscopic colonoscopy for the diagnosis of neoplasia in flat and depressed lesions of the colorectum: a prospective analysis.  Gut. 2004;  53(2) 284-290
  • 58 Hurlstone D P, Cross S S, Brown S, Sanders D S, Lobo A J. A prospective evaluation of high-magnification chromoscopic colonoscopy in predicting completeness of EMR.  Gastrointest Endosc. 2004;  59(6) 642-650
  • 59 Gono K, Obi T, Yamaguchi M et al.. Appearance of enhanced tissue features in narrow-band endoscopic imaging.  J Biomed Opt. 2004;  9(3) 568-577
  • 60 Song L M, Adler D G, Conway J D ASGE TECHNOLOGY COMMITTEE et al. Narrow band imaging and multiband imaging.  Gastrointest Endosc. 2008;  67(4) 581-589
  • 61 Inoue T, Murano M, Murano N et al.. Comparative study of conventional colonoscopy and pan-colonic narrow-band imaging system in the detection of neoplastic colonic polyps: a randomized, controlled trial.  J Gastroenterol. 2008;  43(1) 45-50
  • 62 Adler A, Pohl H, Papanikolaou I S et al.. A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect?.  Gut. 2008;  57(1) 59-64
  • 63 Rex D K, Helbig C C. High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging.  Gastroenterology. 2007;  133(1) 42-47
  • 64 Dekker E, van den Broek F J, Reitsma J B et al.. Narrow-band imaging compared with conventional colonoscopy for the detection of dysplasia in patients with longstanding ulcerative colitis.  Endoscopy. 2007;  39(3) 216-221
  • 65 Su M Y, Hsu C M, Ho Y P, Chen P C, Lin C J, Chiu C T. Comparative study of conventional colonoscopy, chromoendoscopy, and narrow-band imaging systems in differential diagnosis of neoplastic and nonneoplastic colonic polyps.  Am J Gastroenterol. 2006;  101(12) 2711-2716
  • 66 Chiu H M, Chang C Y, Chen C C et al.. A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia.  Gut. 2007;  56(3) 373-379
  • 67 East J E, Suzuki N, Saunders B P. Comparison of magnified pit pattern interpretation with narrow band imaging versus chromoendoscopy for diminutive colonic polyps: a pilot study.  Gastrointest Endosc. 2007;  66(2) 310-316
  • 68 Rastogi A, Bansal A, Wani S et al.. Narrow-band imaging colonoscopy—a pilot feasibility study for the detection of polyps and correlation of surface patterns with polyp histologic diagnosis.  Gastrointest Endosc. 2008;  67(2) 280-286
  • 69 Hirata M, Tanaka S, Oka S et al.. Evaluation of microvessels in colorectal tumors by narrow band imaging magnification.  Gastrointest Endosc. 2007;  66(5) 945-952
  • 70 Machida H, Sano Y, Hamamoto Y et al.. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study.  Endoscopy. 2004;  36(12) 1094-1098
  • 71 van den Broek F J, Reitsma J B, Curvers W L, Fockens P, Dekker E. Systematic review of narrow-band imaging for the detection and differentiation of neoplastic and nonneoplastic lesions in the colon (with videos).  Gastrointest Endosc. 2009;  69(1) 124-135
  • 72 van den Broek F J, Fockens P, van Eeden S et al.. Endoscopic tri-modal imaging for surveillance in ulcerative colitis: randomised comparison of high-resolution endoscopy and autofluorescence imaging for neoplasia detection; and evaluation of narrow-band imaging for classification of lesions.  Gut. 2008;  57(8) 1083-1089
  • 73 Matsumoto T, Kudo T, Jo Y, Esaki M, Yao T, Iida M. Magnifying colonoscopy with narrow band imaging system for the diagnosis of dysplasia in ulcerative colitis: a pilot study.  Gastrointest Endosc. 2007;  66(5) 957-965

Sean E ConnollyM.D. 

Department of Gastroenterology, Ochsner Clinic Foundation

1514 Jefferson Hwy., New Orleans, LA 70121

eMail: Sconnolly@ochsner.org

    >