Chromoendoscopy, narrow-band imaging colonoscopy, and autofluorescence colonoscopy for detection of diminutive colorectal neoplasia in familial adenomatous polyposis.

Abstract

This study was designed to compare the diagnostic yield of white light colonoscopy, chromoendoscopy, narrow-band imaging, and autofluorescence imaging in the detection of diminutive lesions. Thirteen patients with adenomatous polyposis were examined by total colonoscopy using an instrument that incorporated both narrow-band and autofluorescence imaging. Colonoscopic images were obtained using white light colonoscopy, autofluorescence imaging, narrow-band imaging, and chromoendoscopy. All images were captured at equivalent angles and distances from the colorectal mucosa. Chromoendoscopy detected the greatest number of lesions at all sites within the large intestine, and it detected a significantly greater number than the other procedures on the left side of the large intestine. Narrow-band imaging depicted a greater number of lesions than did white light in the transverse colon, descending colon, and rectum. Autofluorescence imaging showed a greater number of lesions than did white light in the rectum. The total number of depicted lesions under chromoendoscopy (43.3 +/- 38.5) was significantly greater than the total number detected with white light (12.2 +/- 13.9, P = 0.005), autofluorescence imaging (21.4 +/- 27.5, P = 0.0006), and narrow-band imaging (20.1 +/- 21.5, P = 0.003). Narrow-band imaging detected a significantly higher total number of lesions than did white light (P = 0.04). Chromoendoscopy is superior to white light colonoscopy, autofluorescence imaging, and narrow-band imaging for detection of diminutive colorectal lesions in adenomatous polyposis.