Clin Endosc.  2011 Sep;44(1):44-50.

Correlation of Narrow Band Imaging with Magnifying Colonoscopy and Histology in Colorectal Tumors

• Yoo HY
• Lee MS
• Ko BM
• Kim HK
• Ahn HS
• Han SH
• Bae JY
• Min SK
• Lee JC
• Ryu CB

Abstract

BACKGROUND/AIMS
Narrow band imaging (NBI) is a new technique that uses optical filters for imaging of mucosal morphology. The aim of this study was to correlate findings of NBI with magnifying colonoscopy and histology for prediction of neoplastic colorectal lesion.
METHODS
Between September 2005 and December 2007, 107 colon polyps from 68 patients were detected by conventional colonoscopy and subsequently evaluated by NBI with magnifying colonoscopy and analyzed for a pit pattern and a capillary pattern. More analysis was done regarding thickness and irregularity of capillary features.
RESULTS
Pit pattern with NBI magnification to discriminate between neoplastic and non-neoplastic lesions had a sensitivity of 88.9% and a specificity of 87.5%; capillary pattern yielded test performance characteristics of 91.9% and 87.5%. In respect of capillary thickness, invisible capillaries were found significantly more often in hyperplastic lesions. All thick capillaries were found in neoplastic polyps, and found significantly more often in carcinomas with submucosal massive invasion (sm-m) (p<0.01). In respect of capillary irregularity, invisible capillaries were found significantly more often in hyperplasic lesions, and severely irregular capillaries were found significantly more often in sm-m lesions (p<0.01).
CONCLUSIONS
Observation of capillary thickness and irregularity by NBI magnification is useful for correlating histological grade with carcinoma, especially with depth of submucosal invasion.

Keyword

Narrow band imaging; Magnifying colonoscopy; Histology; Colorectal tumor

MeSH Terms

Capillaries
Colon
Colonoscopy
Colorectal Neoplasms
Humans
Narrow Band Imaging
Polyps
Sensitivity and Specificity

Figure

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  Fig. 1 Classification of capillary pattern. (A, B) Capillary pattern type I shows absence of meshed brown capillary vessel. (C, D) Capillary pattern type II shows presence of meshed brown capillary vessel, slightly thicker and loose capillary density. (E, F) Capillary pattern type III shows presence of meshed brown capillary vessel, thicker, branching, irregularity of capillary and dense capillary density.

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  Fig. 2 Classification of microvessel thickness as determined by narrow band imaging. (A) Microvessels were classified as thin when they were thin and even thickness. (B) Microvessels were classified as thick when they were uneven thickness.

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  Fig. 3 Classification of microvascular features as determined by narrow band imaging. (A) Microvessels were classified regular when lesions had microvessels running smoothly between pits and an apparent regular meshwork of microvessels throughout. (B) Microvessels were classified irregular when lesions had microvessels running irregularly between pits and an apparent irregular meshwork of microvessels throughout.

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