The composition of cell tissue in a colorectal polyp, as seen by NBI, can be divided into three types called NICE classification:
NICE 1: The polyp’s cell tissue still has a normal composition. In this case, the doctor will order follow-up checks to monitor the development of the polyp. However, he/she will not need to remove the polyp because the chances of it being cancerous are still very slim.
NICE 2: The composition of the cell tissue looks similar to a net, which indicates that the cells could eventually become cancerous. The doctor will therefore remove the polyp immediately using a coil or a special type of electric knife.
NICE 3: The cell tissue appears wild and disorderly, much like cancer cells. In this case, the doctor may not remove the whole polyp using a colonoscope, but may use tissue acquisition instead. The patient will need a consultation with an oncologist to assess which method of removing the polyp is most suitable.
The use of the NBI technique gives a more precise diagnosis. It also makes it easier for the doctor to devise a treatment plan. NBI can identify even the smallest polyps, as little as 5mm in diameter. This, thus, allows the doctor to calculate as accurately as possible whether the polyps pose a risk to the rest of the body. With a white-light colonoscopy, however, such small polyps might go unnoticed.
Still, the effectiveness of any colonoscopy using NBI largely depends on the expertise of the doctor and his/her mastery of the technique. It depends specifically on his/her adeptness at reading the results of the epithelium screening. Moreover, since there are only a small number of doctors who are experts in this technique, hospitals often overlook NBI as a screening option. This should not be the case, however. Infact, NBI offers a safe alternative to chromoendoscopy, as doctors just need to inject the patient with a dye or stain.