Neoplasms

All Conditions

Adenoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Herbal and Botanical

All Drugs and Chemicals

Cola

Use of White Light Endoscopy to detect colonic adenomas.

Using Bright Narrow Band Imaging to detect colonic adenomas.

Bright Narrow Band Imaging.

White Light Endoscopy

Removal of colorectal adenomas prevents the occurence of colorectal cancers. The use of chromo-endoscopy has been shown to improve the detection of flat adenomas. Narrow band imaging enables endoscopists to accurately describe the pit pattern of adenomas. By comparing White Light Endoscopy and Bright Narrow Band Imaging it will show if there is any comparable advantage to using one or the other for lesion detection and assessment.

Removal of colorectal adenomas prevents occurrence of cancers \[1\]. It is recognized that colonoscopy can miss colorectal adenomas and early cancers \[2\]. There is a need to further improve performance of colonoscopy. The use of chromoendoscopy has been shown to improve detection of flat adenomas \[3\]. Narrow band imaging was introduced in year 2006. It is similar to chromoendoscopy in that it provides more mucosal details. This enables endoscopists to accurately describe the pit pattern of adenomas. NBI has been used as a substitute to chromoendoscopy.

In pooled analysis, NBI is comparable to chromoendoscopy in their sensitivity and specificity in the diagnosis of malignant colorectal adenomas \[4\]. Unfortunately, the use of NBI has not been shown to conclusively improve rate of colorectal adenoma detection. Two of 3 randomized trials that compared WLE to NBI showed a higher adenoma detection rate with the use of NBI \[5, 6\]. In a study by Rex et al., the rate was however similar with either modality. In a pooled analysis, NBI was only marginally better than WLE \[7\].

The effective use of NBI depends on the quality of bowel preparation and the experience of endoscopist. In the presence of fecal matters, NBI tends to be dark and detection of small adenomas becomes difficult. The prototype bright NBI coupled with high definition resolution is likely to overcome this drawback of original NBI.

Comparison Between White Light Endoscopy and Bright Narrow Band Imaging in Diagnosis Colonic Adenomas.

A Randomised Comparison Between White Light Endoscopy (WLE) and Bright Narrow Band Imaging (B-NBI) in the Diagnosis of Colonic Adenomas in Asymptomatic Subjects Undergoing Screening Colonoscopy.

It is anticipated that colorectal adenomas will be more easily identifiable using Bright Narrow Band Imaging.

It is anticipated that the use of Bright Narrow Band Imaging will significantly improve the histological detection of colonic adenomas when detected as opposed to White Light Endoscopy.

Professor Michael Bourke

Director of Gastrointestinal Endoscopy

It is a High Definition system with narrow band imaging option in th endoscope.

Bright Narrow Band Imaging

White light Endoscopy

James YW LAU, MD

Early detection of colo-rectal adenoma using colonoscopy can prevent occurrence of colon cancers. While colonoscopy is a standard technique, it can miss early cancers. To improve the detection rate, Narrow Band Imaging (NBI) was introduced in 2006. It has been shown to compare favorably with chromo-endoscopy in the sensitivity and specificity in the diagnosis of malignant colo-rectal neoplasms. The major drawback of NBI is that images become dark in the presence of blood and fecal matters. The bright-NBI is a prototype imaging technology that enables endoscopists to obtain better images in suboptimal conditions. The study proposes to compare the performance of colonoscopy using either white light or bright NBI in subjects undergoing screening colonoscopy in search for colon adenomas.

Purpose

To determine that bright -NBI is superior to WLE in detecting colorectal adenomas in average risk subjects undergoing screening colonoscopy.

Removal of colorectal adenomas prevents occurrence of cancers \[1\]. It is recognized that colonoscopy can miss colorectal adenomas and early cancers \[2\]. There is a need to further improve performance of colonoscopy. The use of chromo-endoscopy has been shown to improve detection of flat adenomas \[3\]. Narrow band imaging was introduced in year 2006. It is similar to chromo-endoscopy in that it provides more mucosal details. This enables endoscopists to accurately describe the pit pattern of adenomas. NBI has been used as a substitute to chromo-endoscopy. In pooled analysis, NBI is comparable to chromo-endoscopy in their sensitivity and specificity in the diagnosis of malignant colorectal adenomas \[4\]. Unfortunately, the use of NBI has not been shown to conclusively improve rate of colorectal adenoma detection. Two of 3 randomized trials that compared WLE to NBI showed a higher adenoma detection rate with the use of NBI \[5, 6\]. In a study by Rex et al., the rate was however similar with either modality. In a pooled analysis, NBI was only marginally better than WLE \[4\].

The effective use of NBI depends on the quality of bowel preparation and the experience of endoscopist. In the presence of fecal matters, NBI tends to be dark and detection of small adenomas becomes difficult. The prototype bright NBI coupled with high definition resolution is likely to overcome this drawback of original NBI.

Diagnosis of Colonic Adenomas by Bright Narrow Band Imaging (B-NBI)

A Randomized Comparison Between White Light Endoscopy (WLE) and Bright Narrow Band Imaging (B-NBI) in the Diagnosis of Colonic Adenomas in Asymptomatic Subjects Undergoing Screening Colonoscopy

compare the rate in colorectal adenoma detection between B-NBI and conventional colonoscopy

compare the advanced neoplasm detection rate

compare the sensitivity and specificity between B-NBI and conventional colonoscopy

Chinese University of Hong Kong

Professor

Symptoms and General Pathology

Recurrence

Colonic Polyps

Polyps

Disease Attributes

Patients do not receive Snare Tip Soft Coagulation to the edge of the endoscopic resection defect

Patients to receive Snare Tip Soft Coagulation to the edge of the endoscopic resection defect

Snare Tip Soft Coagulation

No Snare Tip Soft Coagulation

Michael Bourke, FRACP, MBBS

Recurrence after endoscopic mucosal resection of laterally spreading lesions (LSL) \>= 20mm in size occurs in approximately 20% of cases at surveillance colonoscopy. We aim to evaluate the efficacy of prophylactic adjuvant thermal ablation of the EMR mucosal defect margin in reducing adenoma recurrence following colonic EMR.

Patients were blinded to the treatment allocation. The endoscopists performing the index and surveillance procedures were not blinded to the treatment.

Soft Coagulation for the Prevention of Adenoma Recurrence

Soft Coagulation for the Prevention of Adenoma Recurrence After Endoscopic Mucosal Resection (EMR) of Large Sessile Colonic Polyps: A Multicentre, Randomized Trial.

Presence of residual/recurrent adenoma at the EMR scar at endoscopic follow-up

Presence of residual/recurrent adenoma on biopsy of the endoscopic resection scar

Rate of 'en bloc resection' (removing entire lesion in one snare) with histologically confirmed clear margins

The number of snare resections needed to achieve complete clearance

Bleeding after EMR requiring admission or repeat intervention

Number of injections required for haemostasis

Delayed perforation requiring intervention or readmission

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Comparison Between White Light Endoscopy and Bright Narrow Band Imaging in Diagnosis Colonic Adenomas.	NCT01737567	Colonic Adenoma...	Bright Narrow B... White Light End...	50 Years - 99 Years	Western Sydney Local Health District
Comparison Between White Light Endoscopy and Bright Narrow Band Imaging in Diagnosis Colonic Adenomas.	NCT01737567	Colonic Adenoma...	Bright Narrow B... White Light End...	50 Years - 99 Years	Western Sydney Local Health District
Diagnosis of Colonic Adenomas by Bright Narrow Band Imaging (B-NBI)	NCT01422577	Colonic Adenoma...	Bright Narrow B... White light End...	40 Years -	Chinese University of Hong Kong
Soft Coagulation for the Prevention of Adenoma Recurrence	NCT01789749	Colonic Adenoma...	Snare Tip Soft ... No Snare Tip So...	18 Years -	Western Sydney Local Health District
Soft Coagulation for the Prevention of Adenoma Recurrence	NCT01789749	Colonic Adenoma...	Snare Tip Soft ... No Snare Tip So...	18 Years -	Western Sydney Local Health District

Spots Global Cancer Trial Database for colonic adenomas