A randomized crossover open trial of the adenoma miss rate for narrow band imaging (NBI) versus flexible spectral imaging color enhancement (FICE)
Narrow band imaging (NBI) and flexible spectral imaging color enhancement (FICE) allow improved contrasted evaluation of the mucosal surface. However, no study has compared the utility of these two modalities. Therefore, the aim of this study was to compare the adenoma miss rate (AMR) between NBI and FICE. A total of 55 patients (38 men, 17 women) were enrolled in this study. Patients were randomly assigned to the NBI–FICE group (NBI followed by FICE) or the FICE–NBI group (FICE followed by NBI). NBI and FICE total colonic observations were tandemly performed for each patient during the scope withdrawal with white light following cecal intubation. All detected polyps with the NBI or FICE observation were categorized into three groups according to the size and number of polyps missed. Twenty-nine patients were assigned to the NBI–FICE group, and 26 patients were assigned to the FICE–NBI group. There was no significant difference in the overall AMR when comparing the image-enhanced endoscopy technologies (17.9 % for NBI, 26 % for FICE, p = 0.159). AMR was lower for NBI than for FICE for adenomas <5 mm in diameter (5.7 % for NBI, 12.6 % for FICE, p = 0.036). AMR was not significantly different when comparing NBI and FICE for lesions 5 to 10 mm (p = 0.967) or for lesions ≥10 mm (p = 0.269). This study demonstrated that overall AMR was not different when comparing NBI and FICE.