Narrow-band imaging versus white light for the detection of proximal colon serrated lesions: a randomized, controlled trial

Background: The value of narrow-band imaging (NBI) for detecting serrated lesions is unknown. Objective: To assess NBI for the detection of proximal colon serrated lesions. Design: Randomized, controlled trial. Setting: Two academic hospital outpatient units. Patients: Eight hundred outpatients 50 years of age and older with intact colons undergoing routine screening, surveillance, or diagnostic examinations. Interventions: Randomization to colon inspection in NBI versus white-light colonoscopy. Main Outcome Measurements: The number of serrated lesions (sessile serrated polyps plus hyperplastic polyps) proximal to the sigmoid colon. Results: The mean inspection times for the whole colon and proximal colon were the same for the NBI and white-light groups. There were 204 proximal colon lesions in the NBI group and 158 in the white light group (P =.085). Detection of conventional adenomas was comparable in the 2 groups. Limitations: Lack of blinding, endoscopic estimation of polyp location. Conclusion: NBI may increase the detection of proximal colon serrated lesions, but the result in this trial did not reach significance. Additional study of this issue is warranted.