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Narrow Band Imaging™ Technology

Olympus developed narrow band imaging technology to enhance observation of mucosal tissue. Now with the EVIS EXERA III™ endoscopy system, an improved version gives twice the viewable distance and is significantly brighter.7

NBI™ Technology is an optical imaging technology that enhances the visibility of vessels and other tissue on the mucosal surface. NBI technology works by filtering the white light into specific light wavelengths that are absorbed by hemoglobin and penetrate only the surface of human tissue. As a result, with Narrow Band Imaging, capillaries on the mucosal surface are displayed in brown and veins in the submucosa are displayed in cyan on the monitor.2

Note: NBI™ technology is not intended to replace histopathology as means of diagnosis

2 sets of arrows bouncing off the surface of human tissue
 
 
 
 
Olympus® Narrow Band Imaging technology has clinical applications for both upper GI and Lower GI and is recognized as an important technology by the ASGE for: Adopting real-time imaging–assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett’s esophagus3 and Adopting real-time endoscopic assessment of the histology of diminutive colorectal polyp.4
Doctor looking at an NBI image on a monitor

Upper GI Benefits

See Before You Sample – High-definition Narrow Band Imaging targets suspicious areas to biopsy for Barrett’s Esophagus.1

A picture of an Endoscope next to an picture of a surgeon

Lower GI Benefits

Suspect Before You Resect – High-definition Narrow Band Imaging can be used to assess the histology of diminutive colorectal polyps.2

Increased Adenoma Detection Rate – During randomized clinical trials, the use of Second Generation NBI Technology resulted in a statistically significant and clinically relevant increase in ADR.5

 
 

Suspect Before You Resect

in conjunction with EVIS EXERA III endoscopy system
Distinguishable Differences
Narrow Band Imaging assists an experienced endoscopist employing a validated polyp classification system such as the NBI International Colorectal Endoscopic (NICE) classification with high confidence, in distinguishing diminutive adenomatous polyps from non-adenomatous polyps during colonoscopy.2
Experienced endoscopists using Narrow Band Imaging technology demonstrated 93% sensitivity (89-96%, 95% Confidence Interval, 59-98% range) in predicting adenomatous histology of diminutive polyps during colonoscopy when made with high confidence.2
93% Sensivity
85% Specificity
Endoscopists using Narrow Band Imaging technology demonstrated 85% specificity (74-92%, 95% Confidence Interval, 44-99% range) in predicting adenomatous histology of diminutive polyps during colonoscopy when made with high confidence.2
Experienced endoscopists using Narrow Band Imaging technology demonstrated >90% Negative Predictive Value in predicting adenomatous histology of diminutive polyps during colonoscopy when made with high confidence.2
Greater than 90% negative predictive value
HIGH CONFIDENCE PREDICTIONS
In a randomized clinical trial, endoscopists using near focus mode colonoscopes with NBI technology were more likely to make high confidence predictions of diminutive polyp histology than those using standard focus colonoscopies.2
Narrow Band Imaging-assisted endoscopists have achieved >90% agreement with pathological analysis in assigning post-polypectomy patient surveillance intervals following colonoscopy2
GREATER THAN 90% AGREEMENT WITH PATHOLOGICAL ANALYSIS
ASGE
Narrow Band Imaging technology has met the American Society for Gastrointestinal Endoscopy (ASGE) Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) thresholds for real-time assessment of diminutive colorectal polyps by expert endoscopists when optical biopsy assessment was made with high confidence.2

Detection Means Prevention

Increasing adenoma detection rate (ADR) may improve the ability to save lives. A 1% increase in ADR results in a 3% decrease in the risk of interval cancer and a 5% decrease in the risk of a fatal interval colorectal cancer.6

Review the study summary.

FIGURE 1
ADR by Bowel Preparation
Figure 1: ADR by Bowel Preparation
FIGURE 2
ADR by NBI Generation
Figure 2: ADR by NBI Generation

**A p-value less than 0.05 (typically ≤ 0.05) is statistically significant.

5.8%
In cases with “best” bowel preparation, NBI Technology increased ADR compared to WLE by 5.8%.

No significant difference was observed in the adequate bowel preparation group (OR, 1.07; 95% CI, 0.92–1.24; P = 0.38). However, the odds of detecting at least 1 adenoma in the “best” bowel preparation group was significantly higher with NBI compared to WLE (OR, 1.30; 95% CI, 1.04–1.62; P = 0.02**).

(Figure 1)

6%
Second Generation NBI™ Technology* was shown to increase ADR by up to 6% compared to WLE

The odds of detecting at least 1 adenoma with second-generation bright NBI* vs white light was significantly higher than with WLE (OR, 1.28; 95% CI, 1.05–1.56; P =0.02); however, this effect was not observed for first-generation NBI (OR, 1.06;95% CI, 0.91–1.24; P=0.48).

(Figure 2)

Don't leave biopsy to chance.

Olympus’ High-Definition Narrow Band Imaging (HD NBI) technology has enhanced visual observation of mucosal and vascular patterns for five years. Now you can use HD NBI technology to target suspicious areas in Barrett’s esophagus patients for biopsy. The ability to take fewer biopsies saves valuable time, while providing the same great level of patient care.1
White Light - NBI

Better Interpretation Tool
HD NBI technology provides contrast, which may aid in the interpretation of mucosal morphology, vascular patterns, and blood vessel appearance in patients with Barrett’s esophagus.1

Less Time
HD NBI technology facilitates targeted biopsies in patients with Barrett’s esophagus, which can save valuable procedure time.1

Fewer Biopsies
Using HD NBI technology to target suspicious areas in Barrett’s.1

A doctor looking at his laptop

Olympus Continuum

Olympus offers professional education courses on a wide variety of Endoscopy topics, including two dedicated on-demand trainings for use of NBI technology within Gastrointestinal Endoscopy.

LEARN MORE
Healthcare workers in a group setting listening to a person in the group speaking

NBI Technology for Colonoscopists

Healthcare workers in a classroom setting smiling

NBI Technology Barrett’s Esophagus Module

 
 

1. Data held on file with Olympus (K100584) as of 07/02/2010

2. Data held on file with Olympus (K192793) as of 07/17/2020

3. ASGE Technology Committee et al. “ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett’s esophagus.” Gastrointestinal endoscopy vol. 83,4 (2016): 684-98.e7. doi:10.1016/j.gie.2016.01.007

4. ASGE Technology Committee et al. “ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps.” Gastrointestinal endoscopy vol. 81,3 (2015): 502.e1-502.e16. doi:10.1016/j.gie.2014.12.022

5. Atkinson NSS, Ket S, Bassett P, et al. Gastroenterology. 2019;157:462–71.

6. Corley DA, Jensen CD, Marks AR, et al. Adenoma Detection Rate and Risk of Colorectal Cancer and Death. N Engl J Med. 2014;370(14):1298-1306.

7. Data held on file with Olympus (K121959) as of 01/10/2013

* first-generation NBI technology refers to EVIS LUCERA SPECTRUM™ ENDOSCOPY SYSTEM or EXERA II™ ENDOSCOPY SYSTEM

* second generation NBI technology (bright) refers to EVIS LUCERA ELITE™ ENDOSCOPY SYSTEM or EVIS EXERA III™ ENDOSCOPY SYSTEM

Note: NBI is not intended to replace histopathological sampling as a means of diagnosis.