The goal of colonoscopy is to identify and remove premalignant and malignant polyps. During colonoscopy it is not feasible to differentiate with certainty if a polyp is benign or premalignant, resulting in removal of all polyps via polypectomy. In attempts to overcome this clinical dilemma, techniques such as chromendoscopy have been developed to aid in improving the accuracy of identifying precancerous polyps. Chromendoscopy helps detect suspicious polyps using a dye spraying technique, but it is time consuming and causes collateral distortion of the adjacent mucosal field. Recently, narrow band imaging (NBI) has been able to highlight abnormal mucosal topography and microvasculature by illuminating with narrow range blue light. This is achieved with the click of a button on the endoscope, and the accuracy of differentiating between abnormal and normal mucosa is equivalent to chromendoscopy. NBI and other similar technologies will likely provide an electronic, easier alternative to chromoendoscopy to aid the endoscopist in differentiation among benign, premalignant, and malignant mucosal patterns.
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