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Endoscopy 2017; 49(03): 304
DOI: 10.1055/s-0042-124364
Letter to the editor
© Georg Thieme Verlag KG Stuttgart · New York

Blue-laser imaging and new-generation narrow-band imaging may both be suitable for the detection of colorectal neoplasms

Qing-Wei Zhang
1   Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, Shanghai, China
,
La-Mei Teng
1   Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, Shanghai, China
2   Division of Gastroenterology and Hepatology, Liqun Clinical Medicine College, The Second Military Medical University, Liqun Hospital, Shanghai, China
,
Xin-Tian Zhang
1   Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, Shanghai, China
,
Xiao-Bo Li
1   Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University; Shanghai Institute of Digestive Disease, Shanghai, China
› Author Affiliations
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Publication Date:
01 March 2017 (online)

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We read with interest the recent article by Shimoda et al. [1] evaluating the adenoma detection ability of a new advanced endoscopic imaging, named blue-laser imaging (BLI), compared with white-light imaging (WLI). The authors concluded that BLI did not improve the adenoma detection rate but had lower colon adenoma miss rates compared with WLI. However, we have some questions as follows.

First, this study was considered as a randomized tandem trial with patients randomized to BLI followed by WLI or to WLI followed by WLI. We think the design would be better if the second group was randomized to undergo WLI followed by BLI. The actual number of missed adenomas may be higher than the reported number for WLI. In addition, the number of patients with one or more adenoma in the WLI – WLI group may also be higher if BLI were conducted after the first WLI examination.

Second, we think that narrow-band imaging (NBI) has shown no superiority over WLI for the detection of colonic adenomas because of low brightness. Actually, new-generation NBI has demonstrated more polyp detection or adenoma detection and improved visibility of polyps [2] [3] [4]. Therefore, we think that both new-generation NBI and BLI-bright may be suitable for the detection of colorectal neoplasms, and validation from a randomized controlled trail is warranted.

 

  • References

  • 1 Shimoda R. Sakata Y. Fujise T. et al. The adenoma miss rate of blue-laser imaging vs. white-light imaging during colonoscopy: a randomized tandem trial. Endoscopy 2016; DOI: 10.1055/s-0042-118450.
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