Original articleClinical endoscopyNarrow-band imaging for the detection of polyps in patients with serrated polyposis syndrome: a multicenter, randomized, back-to-back trial

BackgroundSerrated polyposis syndrome (SPS) is characterized by the presence of multiple serrated polyps spread throughout the colon. Patients with SPS are considered to be at risk of colorectal cancer and are advised to undergo endoscopic surveillance. Narrow-band imaging (NBI) may improve the detection of polyps during these surveillance colonoscopies.ObjectiveTo compare polyp miss rates between NBI and high-resolution white-light endoscopy (HR-WLE).DesignMulticenter, randomized, crossover study.SettingFour tertiary referral institutions.PatientsA total of 52 patients with SPS undergoing surveillance colonoscopy.InterventionAll patients underwent back-to-back colonoscopies with HR-WLE and NBI in a randomized order.Main Outcome MeasurementsPolyp miss rates of HR-WLE and NBI.ResultsIn the HR-WLE group, 116 polyps were detected during the first inspection. A second inspection with NBI added 47 polyps, resulting in an overall polyp miss rate of 29% with HR-WLE (95% confidence interval, 22-36). In the NBI group, a total of 128 polyps were detected during the first inspection. Subsequent inspection with HR-WLE added 32 polyps, resulting in an overall polyp miss rate of NBI of 20% (95% confidence interval, 15-27). Comparison of the overall polyp miss rates of HR-WLE and NBI showed no significant difference (P = .065).LimitationsSmall sample size; second inspection was performed by the same endoscopist.ConclusionsThe results of our study suggest that NBI does not reduce polyp miss rates in patients with SPS compared with HR-WLE. Further multinational studies with larger numbers of patients are warranted to verify these results. (Clinical trial registration number: NTR2497.)