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Electronic chromoendoscopy improves adenoma, neoplasia detection
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Electronic chromoendoscopy improved adenoma and neoplasia detection rates during colonoscopies in a study published in Clinical Gastroenterology and Hepatology.
Trilokesh D. Kidambi, MD, of the division of gastroenterology at City of Hope Medical Center in Duarte, California, and colleagues wrote that electronic chromoendoscopy provides a detailed view of the colon mucosal surface using contrast enhancement without needing the help of a dye.
“Recently, i-scan [Pentax Medical] was developed as a novel push-button electronic chromoendoscopy tool that uses a post-processing light filter technology with software algorithms to enhance the definition of the epithelial surface and emphasizes the contrast of the mucosal surface and vessels,” the researchers wrote. “However, data is limited on its effectiveness in improving adenoma detection.”
Kidambi and colleagues compared i-scan with high definition white light (HDWL) endoscopy in a randomized, controlled study of patients scheduled to undergo surveillance for colorectal neoplasia.
The investigators randomly assigned patients to undergo screening with i-scan (n = 357) or HDWL (n = 358). In addition to the primary outcome of adenoma detection rate, secondary outcomes included sessile serrated polyp and neoplasia detection, as well as location, size and morphology of polyps.
Researchers found that the ADR was higher among the group of patients who underwent electronic chromoendoscopy compared with the HDWL group (47.2% vs. 37.7%; P = .01), and that neoplasia detection rates also were higher in the electronic chromoendoscopy group compared with the HDWL group (56.4% vs. 46.1%; P = .005).
Additionally, investigators found that the increase in ADR was associated with improved detection of diminutive, flat adenomas in the right colon.
Kidambi and colleagues wrote that electronic chromoendoscopy has the potential to help improve ADR, but their findings need to be confirmed in a mutlicenter trial and with endoscopists with low-baseline ADR.
“I-scan 1 showed a nearly 10% increase in ADR compared to HDWL, as well as improved detection of subtle, small, flat, right-sided polyps,” they wrote. “Taken together, our findings suggest that i-scan is a safe and effective optical technology for improving colorectal neoplasia detection during colonoscopy.” – by Alex Young
Disclosures: Kidambi reports no relevant financial disclosures. Please see the full study for other author’ relevant financial disclosures.
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