INTRODUCTION Linear-array endoscopic ultrasound (EUS) and narrow-band imaging (NBI) are both used to estimate the invasion depth of nonpedunculated rectal lesions (NPRLs). However, it is unclear which procedure is more accurate. This randomized controlled trial aimed to compare the diagnostic accuracy of linear EUS and NBI for estimating the invasion depth of NPRLs. METHODS This study is a single-center, randomized, tandem trial. Eligible patients with NPRLs were randomly assigned to A group (assessment with EUS followed by NBI) or B group (assessment with NBI followed by EUS). The invasion depth of each lesion was independently measured by each procedure and categorized as mucosal to slight submucosal (M-SM s , invasion depth <1,000 μm) or deep submucosal (SM d , invasion depth ≥1,000 μm) invasion, with postoperative pathology as the standard of measurement. The primary outcome was diagnostic accuracy, and secondary outcomes included sensitivity, specificity, and procedure time. RESULTS Eighty-six patients with NPRLs were enrolled, and 79 patients were finally analyzed, including 39 cases in the A group and 40 cases in the B group. Comparable diagnostic accuracies were observed between EUS and NBI (96.2% vs 93.7%, P = 0.625). EUS identified lesions with deep submucosal invasion with 81.8% sensitivity while that of NBI was 63.6% ( P = 0.500). The specificity of both EUS and NBI was 98.5%. The procedure time was also similar between EUS and NBI (5.90 ± 3.44 vs 6.4 ± 3.94 minutes, P = 0.450). Furthermore, the combined use of EUS and NBI did not improve diagnostic accuracy compared with EUS or NBI alone (94.9% vs 96.2% vs 93.7%, P = 0.333). DISCUSSION Linear EUS and NBI measure the invasion depth of NPRLs with comparable accuracy. The combination of the 2 methods does not improve the diagnostic accuracy. Single NBI should be preferred, considering its simplicity and convenience in clinical practice.

中文翻译：

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基于随机对照试验，线性阵列内窥镜超声和窄带成像以相当的精度测量无蒂直肠病变的浸润深度。


简介 线性阵列内窥镜超声 (EUS) 和窄带成像 (NBI) 均用于估计无蒂直肠病变 (NPRL) 的浸润深度。然而，尚不清楚哪种程序更准确。这项随机对照试验旨在比较线性 EUS 和 NBI 评估 NPRL 侵袭深度的诊断准确性。方法 本研究是一项单中心、随机、串联试验。符合条件的 NPRL 患者被随机分配到 A 组（先进行 EUS 评估，然后进行 NBI）或 B 组（先进行 NBI 评估，然后进行 EUS）。每个手术均独立测量每个病变的浸润深度，并将其分为粘膜至轻度粘膜下（M-SM s ，浸润深度<1,000 μm）或深层粘膜下（SM d ，浸润深度≥1,000 μm）浸润，术后病理为测量标准。主要结果是诊断准确性，次要结果包括敏感性、特异性和手术时间。结果共纳入NPRL患者86例，最终分析79例，其中A组39例，B组40例。 EUS 和 NBI 的诊断准确率相当（96.2% vs 93.7%，P = 0.625）。 EUS 识别深部粘膜下浸润病变的敏感性为 81.8%，而 NBI 的敏感性为 63.6%（P = 0.500）。 EUS 和 NBI 的特异性均为 98.5%。 EUS 和 NBI 的手术时间也相似（5.90 ± 3.44 vs 6.4 ± 3.94 分钟，P = 0.450）。此外，与单独使用 EUS 或 NBI 相比，联合使用 EUS 和 NBI 并没有提高诊断准确性（94.9% vs 96.2% vs 93.7%，P = 0.333）。讨论 线性 EUS 和 NBI 以相当的精度测量 NPRL 的浸润深度。 两种方法的结合并不能提高诊断准确性。考虑到临床实践中的简单性和便利性，应优先考虑单一 NBI。