Like television, endoscopy has entered the era of high-definition (HD) imaging. Using state-of-the-art endoscopes with large LCD HD screens, the lining of the esophagus, stomach, small intestine, and colon can be seen with incredible, crisp detail. This can improve the accuracy of colonoscopy when screening for polyps or cancer, and, when used in conjunction with Narrow Band Imaging (NBI), can enable the gastroenterologist to be able to better predict the significance of an abnormal finding such as a colon polyp or a reddish area in the esophagus (e.g. Barrett’s esophagus).
NBI is a new technology which utilizes a blue light (incorporated into the same high-definition equipment described above) to visualize in even greater detail the surface patterns and blood vessels of abnormal lesions such as polyps. Researchers in our department have demonstrated that trained endoscopists can use NBI to predict whether a colon polyp, for example, is the “good” type or the “bad” type that needs to be removed with an accuracy rate approaching 90%. NBI can also be helpful in identifying the margins of large polyps or early cancers and guiding endoscopic resection. Similarly, NBI is helpful in defining the extent of Barrett’s esophagus, particularly when performing endoscopic mucosal resection (EMR) or radiofrequency ablation (RFA).