Narrow band imaging at colonoscopy: seeing through a glass darkly or the light of a new dawn?

摘要

Narrow band imaging (NBI) is a noveln‘blue light’ endoscopic imaging technologynthat enhances contrast for superficialnmucosal capillaries and has been studiednin the upper and lower GI tract,noro–pharynx, lung, and bladder [1–6]. Innthe colon, adenomatous polyps have annincreased microvascular density, andntherefore may be highlighted by NBI [7].nThe superficial microcapillary plexus thatnsurrounds each colonic crypt may be seennwith NBI and magnification and can leadnto an appearance very similar to the ‘pitnpattern’ that can be seen using chromoendoscopyn‘dye spray’. Indeed, NBI hasnbeen described as ‘electronic chromoendoscopy’nalthough the patterns seennmay not be exactly identical [8]. Morensimply, NBI with magnification allows andirect appreciation of the increasednmicrovascular density seen in adenomasndescribed as ‘meshed brown capillary vessels’,n‘strong vascular pattern intensity’nand ‘brown hue’ allowing easy differentiationnfrom non-neoplastic polyps [2,8,9].nClinical data on the use of NBI atncolonoscopy for lesion detection, differentiationnand assessment of potentialninvasion in both routine colonoscopy,nhigher risk surveillance, and in colitis arennow accumulating. As NBI is now availablencommercially it may be appropriatento consider what its role might be in ournroutine clinical practice.