Comparison of Performance between White Light Imaging and Narrow Band Imaging in Distinguishing Neoplastic and Non-neoplastic Colorectal Polyps

Background: White light imaging (WLI) is the current standard colonoscopy technique for diagnosing colorectal polyps in Indonesia. Various endoscopic imaging techniques have been developed to improve the accuracy of diagnosing colorectal polyps, one of which is narrow band imaging (NBI). We conducted a diagnostic study comparing the performance of NBI against WLI in distinguishing neoplastic from non-neoplastic colorectal polyps. Methods: This was a diagnostic study that analyzes endoscopic pictures of colorectal polyps in patients who underwent colonoscopy using the WLI and NBI techniques. Previously collected biopsy tissue specimens were re-examined by a single pathologist. Results: There were 117 subjects analyzed, and the proportion of subjects with neoplastic polyps was 65.8%. Common indications for colonoscopy were hematochezia (24.8%) and abdominal pain (23.9%). WLI showed moderate inter-observer reliability (kappa value = 0.591), while NBI showed significant reliability (kappa value = 0.674). NBI demonstrated better sensitivity (84.4%; 95% CI 74.4%–91.7%) and accuracy (78.6%; 95% CI 70.1%–85.7%) compared with WLI (sensitivity 74%; 95% CI 62.8%–83.4% and accuracy 71.8%; 95% CI 62.7%–79.7%). However, the specificity was the same (67.5%; 95% CI 50.9%–81.4%). Conclusion: NBI has better performance than WLI in distinguishing neoplastic and non-neoplastic colorectal polyps.