M Okada, H Sakamoto, T Takezawa… - Clinical Endoscopy, 2016 

Colonoscopy has been shown to decrease the incidence of colorectal cancer and cancer death through the removal of adenomatous polyps. To make an accurate diagnosis of colorectal neoplasms, several image-enhanced endoscopic systems, such as narrow band imaging (NBI), flexible spectral imaging color enhancement, and blue laser imaging (BLI), have been developed. However, no significant differences have been reported in the adenoma detection rate between image-enhanced endoscopy and conventional white light endoscopy.1 NBI and BLI are often criticized for darkening the endoscopy image and, in turn, hampering a wider view of the colon.2 Moreover, the miss rate for flat lesions was significantly higher than that for pedunculated lesions.3 We present a case that suggests a possible improvement in adenoma detection rates, especially for flat adenomas.