The Effects of High Definition (HD), Electronic Magnification (EM), White Light (WL) and Narrow Band Imaging (NBI) on the Detection of Adenomatous, Hyperplastic and Non-Neoplastic Polyps at Screening Colonoscopy

Purpose: The role of newly introduced and available optical technologies upon polyp detection at colonoscopy is controversial. Aim: To determine and compare the detection rate of tubular adenomas (TA), hyperplastic (HP), and non-neoplastic (NN) polyps during screening colonoscopy. Methods: Patients undergoing screening colonoscopy using either of the following optical technology combinations upon withdrawal of the scope were included: White light with high definition and electronic magnification (WL/HD+/EM+); White light with high definition but without electronic magnification (WL/HD+/EM−) White light without high definition and without electronic magnification (WL/HD-/EM−) or, Narrow band imaging with high definition and with electronic magnification (NBI/HD+/EM+) EM was set at 1.5 X For the HD with/without EM studies the Olympus 180H series scopes were used; for the non-HD studies, the Olympus PCF- and CFQ-180 scopes were utilized. All polyps seen during colonoscopy were removed. Histology was used as the final diagnosis for the polyps removed. Non-neoplastic polyps were defined as: normal mucosa, prominent lymphoid aggregates or hyperplastic mucosa on histopathological evaluation. Setting: Endoscopy unit at a VAMC. Statistical analysis: Proportional data was compared using the Chi-square test. A P < 0.05 was considered statistically significant. Results: A total of 600 patients underwent screening colonoscopy: 400 used WL with (291) or without (109) HD; 200 used NBI with HD. The results of the polyp detection are summarized in the Table. There were no statistically significant differences in the detection rates of TAs, HP and NN polyps among the different optical techniques used.Table: Detection rate for tubular adenomas, hyperplastic and non-neoplastic polyps.Conclusion: 1. The detection rates for adenomatous, hyperplastic and non-neoplastic polyps were not affected by the different optical technologies evaluated. 2. This data supports our previous work suggesting that the detection of missed pathology (at tandem colonoscopy) is independent of the endoscope optics used.