Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Gastrointestinal Center, Urasoe General Hospital, Okinawa, Japan.
Dig Endosc. 2023 May;35(4):453-470. doi: 10.1111/den.14489. Epub 2023 Jan 18.
Narrow-band imaging (NBI) is an optical digital enhancement method that allows the observation of vascular and surface structures of colorectal lesions. Its usefulness in the detection and diagnosis of colorectal polyps has been demonstrated in several clinical trials and the diagnostic algorithms have been simplified after the establishment of endoscopic classifications such as the Japan NBI Expert Team classification. However, there were issues including lack of brightness in the earlier models, poor visibility under insufficient bowel preparation, and the incompatibility of magnifying endoscopes in certain endoscopic platforms, which had impeded NBI from becoming standardized globally. Nonetheless, NBI continued its evolution and the newest endoscopic platform launched in 2020 offers significantly brighter and detailed images. Enhanced visualization is expected to improve the detection of polyps while universal compatibility across all scopes including magnifying endoscopy will promote the global standardization of magnifying diagnosis. Therefore, knowledge related to magnifying colonoscopy will become essential as magnification becomes standardly equipped in future models, although the advent of computer-aided diagnosis and detection may greatly assist endoscopists to ensure quality of practice. Given that most endoscopic departments will be using both old and new models, it is important to understand how each generation of endoscopic platforms differ from each other. We reviewed the advances in the endoscopic platforms, artificial intelligence, and evidence related to NBI essential for the next generation of endoscopic practice.
窄带成像（NBI）是一种光学数字增强方法，可观察结直肠病变的血管和表面结构。在几项临床试验中已经证明了其在结直肠息肉的检测和诊断中的作用，并且在建立了内镜分类（如日本 NBI 专家小组分类）之后，诊断算法已经得到简化。然而，早期的窄带成像设备存在一些问题，包括亮度不足、肠道准备不充分时可视度差以及某些内镜平台上的放大内镜不兼容等，这些问题阻碍了窄带成像在全球范围内的标准化。尽管如此，窄带成像仍在不断发展，2020 年推出的最新内镜平台提供了更亮、更详细的图像。增强的可视化效果有望提高息肉的检测率，而所有内镜（包括放大内镜）的通用兼容性将促进放大诊断的全球标准化。因此，随着未来的模型普遍配备放大功能，与放大结肠镜相关的知识将变得至关重要，尽管计算机辅助诊断和检测的出现可能会极大地帮助内镜医生确保实践质量。鉴于大多数内镜部门将同时使用新旧模型，了解每个内镜平台的代际差异非常重要。我们回顾了内镜平台、人工智能和 NBI 相关证据的进展，这些是下一代内镜实践的基础。
