Improved Scope Detects More Colon Polyps

ORLANDO  –  The addition of 160° of vision to a colonoscope increased adenoma and polyp detections and lowered adenoma and polyp misses, researchers reported here.

Among patients receiving initial colonoscopy with a forward-viewing colonoscope, the Full Spectrum Endoscopy (FUSE) colonoscope had an incremental polyp detection rate of 79.6% versus an initial detection rate of 32.9% and an adenoma detection rate of 75% versus an initial detection rate of 17.1%, according to Iam Gralnek, MD, of the Technion-Israel Institute of Technology in Kesalsaba, and colleagues.

When a different cohort of patients received initial treatment with FUSE, the device had a miss rate of 9.4%  –  versus a miss rate of 44.3% with traditional colonoscope  –  and an adenoma miss rate of 8.1% versus 42.9% with forward-viewing colonoscopy, Gralnek said during an oral presentation at the Digestive Disease Week meeting.

Traditional, forward-viewing colonoscopes only have a viewing angle of 140º to 170º, which can cause a significant percentage of adenomas to be missed behind colonic folds and flexures during a colonoscopy. The Full Spectrum Endoscopy (FUSE) colonoscope uses three imagers and provides a 330° view of the colon, allowing it to see adenomas that may get lost behind folds and flexures.

“I don’t think being able to get to the cecum more quickly is where the real buy-in will be, I think what’s important is the ability to increasingly identify more polyps  –  a technology that will improve that therapy is an advancement,” noted Colleen Schmitt, MD, president elect of the American Society for Gastrointestinal Endoscopy, in an interview with MedPage Today.

The authors conducted a multicenter study of 178 patients who received back-to-back, same-day tandem colonoscopy.

Participants were referred to centers for colorectal cancer screening, polyp surveillance, or diagnostic evaluation and, based on center of treatment, were randomly assigned to receive an initial colonoscopy using traditional or FUSE colonoscope.

Study endpoints included incremental polyp and adenoma detection rates, polyp and adenoma miss rates, time to cecal intubation, withdrawal time, total procedure time, success of therapeutic interventions, and adverse events.

The overall polyp detection rate was 52.6% and the overall adenoma detection rate was 31.7%.

Compared with traditional forward-viewing colonoscopes, FUSE colonoscope imaging had a significantly higher detection rate of additional adenomas (71.4% versus 8.2%, P<0.0001) and a significantly lower adenoma miss rate (7.6% versus 41.7%, P<0.0001).

The FUSE colonoscope also had a higher incremental polyp detection rate and lower polyp miss rate, and was able to more quickly reach the cecum.

Source: http://www.medpagetoday.com/MeetingCoverage/DDW/39368?xid=nl_mpt_DHE_2013-05-24&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g514381d0r&userid=514381&[email protected]&mu_id=5636600