Improvements in narrow band imaging (NBI) may provide an improved view of colonic mucosa for detection of polyps and adenomas. In this issue, Leung et al. report findings to suggest that this next-generation NBI technology is superior to conventional high-definition white light endoscopy in polyp detection. These findings are based on brighter illumination, which has been a problem with older generations of NBI, which did not increase polyp detection but were useful for polyp characterization. Although these findings are very promising for this new role of second-generation NBI in polyp detection, the study must be viewed with consideration of the history of the older NBI system, the analysis of which through multiple positive and negative studies ultimately led to the conclusion that it was not beneficial for detection.
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