Near focus NBI endoscopy plus acetic acid for optical polyp characterization in the colorectum - A proof of principle study.

Optical polyp characterization (OPC) in the colorectum is an upcoming challenge for endoscopists. Narrow band imanging (NBI) has been proposed to be helpful for OPC. However, data from clinical studies have shown that quality of OPC differs markedly between endoscopists. The aim of this study was to test the value of a combined NBI plus acetic acid () approach for OPC in the colorectum. This was a prospective, single-arm study at a tertiary referral center in Germany. The study was designed as a proof of principle study. Initially polyps were characterized using High-definition white light () only. Additionally, the same polyps were investigated using (1.5% solution) in order to predict polyp pathology in a real time setting. The near focus function was used for both and assessment. The primary endpoint was accuracy of colorectal polyp prediction when using . A total of 63 polyps were detected in 55 patients. based accuracy of real-time predictions was 85.5% compared to 80.6% using ( = .450). Accuracy was 90.2% in the high confidence setting for both and predictions. A higher share of polyps were assessed with high confidence when using compared to ( = .006). The use of led to a better identification of polyp margins ( < .001) compared to . The use of acetic acid led to a high level of accuracy and confidence in the prediction of polyp histology. These data justify further investigation in a randomized controlled study.