Endoscopy 2018; 50(04): S29
DOI: 10.1055/s-0038-1637111
ESGE Days 2018 oral presentations
20.04.2018 – Colon: Improving characterization
Georg Thieme Verlag KG Stuttgart · New York

BLI (BLUE LIGHT IMAGING)™ SYSTEM FOR REAL-TIME HISTOLOGY PREDICTION OF SUBCENTIMETRIC COLORECTAL POLYPS

E Rondonotti
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
S Paggi
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
A Amato
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
G Mogavero
2   Gastroenterology Unit, Biomedical Department of Internal and Specialized Medicine (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy
,
A Andrealli
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
G Apinzi
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
F Radaelli
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

The study aim was to compare the accuracy of BLI (Blue light imaging™) system using the NICE (Narrow-band Imaging International Colorectal Endoscopic) classification, with high-definition white light (HDWL) in the histology prediction of subcentimetric colonic polyps.

Methods:

Outpatients undergoing colonoscopy with HD endoscopes (Eluxeo 700 videocolonscopes; Fujifilm Co.; Tokyo, Japan) in which at least one polyp < 10 mm was identified were randomized in two groups. In the HDWL group, histology of polyps < 10 mm was predicted by means of HDWL. In the BLI group the histology was predicted by means of BLI, by applying the NICE classification. Four endoscopists expert in the use of the Narrow Banding Imaging (NBI) system and in the NICE classification, participated in the study. The endoscopist's confidence (high or low) in predicting histology was recorded. Sensitivity, specificity, positive and negative predictive values in predicting histology with high confidence have been calculated comparing endoscopist's prediction with pathology results (reference standard).

Results:

Out of 600 outpatients, 247 (41.2%) had at least one polyp < 10 mm. Of them, 120 and 127 were randomized to HDWL or BLI group, respectively. In the HDWL group, 224 polyps < 10 mm were found, and 193 (86.2%) were evaluated with high confidence. Of them, 130 were histologically-proven adenomas. The sensitivity, specificity, positive and negative predictive value of HDWL in predicting polyp histology with high confidence were 86.9%, 77.8%, 88.9% and 74.2%. In the BLI group, 257 polyps< 10 mm were found and 219 (85.2%) were evaluated with high confidence. Of them, 149 were histologically-proven adenomas. The sensitivity, specificity, positive and negative predictive value of BLI were 93.3%, 87.1%, 93.9% and 87.1%. The accuracy was 83.9% and 91.8% for HDWL and BLI respectively (p = 0.0214).

Conclusions:

The use of BLI significantly improves the endoscopist's accuracy in the real-time characterization of subcentimetric colonic polyps.