High-definition colonoscopy with i-Scan: Better diagnosis for small polyps and flat adenomas

Pier Alberto Testoni, Chiara Notaristefano, Cristian Vailati, Milena Di Leo, Edi Viale

Research output: Contribution to journalArticle

Abstract

Aim: To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. Methods: Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. Results: Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9%) than with the standard white-light technique (408/849 = 48.1%) (P <0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P <0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P <0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions <10 mm (P <0.0001) or nonprotruding (P <0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89 vs 0.95 ± 1.35, P <0.0001). Conclusion: HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps.

Original languageEnglish
Pages (from-to)5231-5239
Number of pages9
JournalWorld Journal of Gastroenterology
Volume18
Issue number37
DOIs
Publication statusPublished - 2012

Fingerprint

Colonoscopy
Polyps
Adenoma
Light
Colonoscopes
Colon
Cecum
Paris
Tertiary Care Centers
Endoscopy
Names
Colorectal Neoplasms
Outpatients
Databases

Keywords

  • Adenoma detection rate
  • Colonic polyps
  • Colonoscopy
  • Contrast enhancement
  • High-definition+ with i-Scan colonoscopy
  • Nonprotruding lesions
  • Surface enhancement
  • Tone enhancement
  • White-light colonoscopy
  • Withdrawal time

ASJC Scopus subject areas

  • Gastroenterology

Cite this

High-definition colonoscopy with i-Scan : Better diagnosis for small polyps and flat adenomas. / Testoni, Pier Alberto; Notaristefano, Chiara; Vailati, Cristian; Leo, Milena Di; Viale, Edi.

In: World Journal of Gastroenterology, Vol. 18, No. 37, 2012, p. 5231-5239.

Research output: Contribution to journalArticle

Testoni, Pier Alberto ; Notaristefano, Chiara ; Vailati, Cristian ; Leo, Milena Di ; Viale, Edi. / High-definition colonoscopy with i-Scan : Better diagnosis for small polyps and flat adenomas. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 37. pp. 5231-5239.
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abstract = "Aim: To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. Methods: Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. Results: Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6{\%}, 24.0{\%}, 21.7{\%} and 24.1{\%} of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4{\%}). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9{\%}) than with the standard white-light technique (408/849 = 48.1{\%}) (P <0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P <0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P <0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions <10 mm (P <0.0001) or nonprotruding (P <0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89 vs 0.95 ± 1.35, P <0.0001). Conclusion: HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps.",
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T1 - High-definition colonoscopy with i-Scan

T2 - Better diagnosis for small polyps and flat adenomas

AU - Testoni, Pier Alberto

AU - Notaristefano, Chiara

AU - Vailati, Cristian

AU - Leo, Milena Di

AU - Viale, Edi

PY - 2012

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N2 - Aim: To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. Methods: Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. Results: Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9%) than with the standard white-light technique (408/849 = 48.1%) (P <0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P <0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P <0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions <10 mm (P <0.0001) or nonprotruding (P <0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89 vs 0.95 ± 1.35, P <0.0001). Conclusion: HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps.

AB - Aim: To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. Methods: Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. Results: Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9%) than with the standard white-light technique (408/849 = 48.1%) (P <0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P <0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P <0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions <10 mm (P <0.0001) or nonprotruding (P <0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89 vs 0.95 ± 1.35, P <0.0001). Conclusion: HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps.

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KW - Contrast enhancement

KW - High-definition+ with i-Scan colonoscopy

KW - Nonprotruding lesions

KW - Surface enhancement

KW - Tone enhancement

KW - White-light colonoscopy

KW - Withdrawal time

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