PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Chromoendoscopy is superior to white light colonoscopy, autofluorescence imaging, and narrow-band imaging for detection of diminutive colorectal lesions in adenomatous polyposis.
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