Optivista image-enhancing endoscopy superior for diagnosis of colorectal polyps
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Optical diagnosis for colorectal polyps using Optivista image-enhancing endoscopy was superior to iScan image-enhancing endoscopy, according to results from Gastrointestinal Endoscopy.
“Both [image-enhancing endoscopy (IEE) systems] achieved [American and European Societies for Gastrointestinal Endoscopy] quality metrics for optical diagnosis for surveillance interval assignment and can be used safely in routine clinical practice,” Roupen Djinbachian, MD, from the division of internal medicine at Montreal University Hospital Center and Montreal University Hospital Research Center and colleagues, said. “[Optivista] IEE should be the preferably used modality, but combining it with [iScan] should be considered as a complementary IEE modality for optical diagnosis of colorectal polyps to achieve optimal pathology prediction, [negative predictive value (NPV)], and surveillance interval assignment.”
Djinbachian and colleagues randomly assigned 410 patients with colorectal polyps between 1 and 5 mm to undergo optical polyp diagnosis with either Optivista (OV) IEE or iScan (IS) IEE. Investigators used a validated IEE scale for optical polyp diagnosis.
"Primary outcome was the agreement of surveillance intervals determined when using OV IEE compared with IS IEE in reference with pathology-based surveillance intervals,” the authors wrote.
Other outcomes included percentage of surveillance intervals that could be given the same day as the procedure, percentage of pathology tests avoided, diagnostic performance and NPV of optical diagnosis for rectosigmoid adenomas.
Investigators noted the polyp detection rate was 58.6% and the adenoma detection rate was 38.8%. The proportion of correct surveillance interval assignment when using OV IEE was 96.5% and 96% with IS IEE (P = .75). Same-day surveillance intervals could be given to 65.1% of patients when using OV IEE compared with 73.1% for IS IEE (P = .07). When using OV IEE, the NPV for rectosigmoid adenomas was 97.5% compared with 88.2% when using IS IEE.
“Using high-confidence optical diagnosis instead of pathology would have resulted in a 44.3% elimination of required pathology examinations for OV IEE vs. 52.8% for IS (P = .34),” Djinbachian and colleagues wrote.
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