Why Haven't Endoscopic Imaging Technologies Changed Colonoscopy Practice?

Despite extensive study of narrow-band imaging (NBI; Olympus), postprocessing methods of i-scan (Pentax) and FICE (Fujinon), confocal laser microscopy (CLE), and autofluorescence (AFI) for determination of polyp histology, these technologies still have not changed daily colonoscopy practice.

In the current meta-analysis, the authors determined the respective sensitivity, specificity, and real-time negative predictive value for adenomas of NBI (56 studies), i-scan (10), FICE (14), CLE (11), and AFI (11), which were:

• NBI: 91.0%, 85.6%, and 82.5%

• i-scan: 89.3%, 88.2%, and 86.5%

• FICE: 91.8%, 83.5%, and 83.7%

• AFI: 86.7%, 65.9%, and 81.5%

• CLE: 93.3%, 89.9%, and 94.8%

In subanalyses (limited to NBI), performance did not clearly differ by polyp size. Syst…