Complementary use of white-light endoscopy and narrow-band imaging for postendoscopic mucosal resection scar assessment: a systematic review and diagnostic meta-analysis.
Otavio Cosendey Martins, Matheus Vanzin Fernandes, Natália Junkes Milioli et al.
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In 30 seconds
This systematic review and diagnostic meta-analysis assessed white-light endoscopy (WLE) and narrow-band imaging (NBI) for detecting recurrence at colorectal endoscopic mucosal resection (EMR) scars during surveillance colonoscopy. Five studies evaluated 848 scars. Pooled sensitivity was 0.799 (95% CI, 0.705-0.868) for WLE and 0.904 (95% CI, 0.843-0.942) for NBI; specificity was 0.950 (95% CI, 0.875-0.981) and 0.936 (95% CI, 0.876-0.968), respectively. The AUC comparison was not statistically significant (P = .461). The authors report that sequential use may improve sensitivity and confidence.
Key findings
- Across 848 scars, pooled recurrence-detection sensitivity was 0.799 (95% CI, 0.705-0.868) for WLE and 0.904 (95% CI, 0.843-0.942) for NBI.
- Pooled specificity was 0.950 (95% CI, 0.875-0.981) for WLE and 0.936 (95% CI, 0.876-0.968) for NBI.
- The comparison between WLE and NBI AUCs yielded P = .461.
Why it matters
Reliable assessment of post-EMR scars is important because missed residual or recurrent neoplasia can affect surveillance, while routine biopsies add cost. These pooled results suggest that NBI may identify more recurrences than WLE, although the AUC comparison did not show a statistically significant difference. The review also highlights sequential imaging as a possible way to support more targeted biopsy decisions.
What to keep in mind
The meta-analysis included only 5 studies, and the abstract does not report further details on study quality or variation between studies.