Endoscopy 2019; 51(03): 237-243
DOI: 10.1055/a-0755-7471
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Impact of endoscopy system, high definition, and virtual chromoendoscopy in daily routine colonoscopy: a randomized trial

Philip Roelandt
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Ingrid Demedts
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Hilde Willekens
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Talat Bessissow
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Lieve Braeye
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Georges Coremans
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Pieter-Jan Cuyle
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Marc Ferrante
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Anne-Marie Gevers
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Martin Hiele
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Maggy Osselaer
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Jan Tack
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Sabine Tejpar
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
3  Department of Oncology, KU Leuven, Leuven, Belgium
,
Marijke Ulenaers
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Gert Van Assche
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Eric Van Cutsem
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
3  Department of Oncology, KU Leuven, Leuven, Belgium
,
Stijn Van Gool
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Jaarke Vannoote
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
,
Severine Vermeire
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
,
Raf Bisschops
1  Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
2  Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
› Institutsangaben
TRIAL REGISTRATION: Diagnostic interventional randomized (parallel assignment) single-center trial NCT03243669 at clinicaltrials.gov
Weitere Informationen

Publikationsverlauf

submitted 18. Februar 2018

accepted after revision 25. September 2018

Publikationsdatum:
15. Januar 2019 (eFirst)

Abstract

Background To improve detection of mucosal lesions during colonoscopy a number of imaging modalities have been suggested, including high definition and virtual chromoendoscopy. Given the theoretical advantage of these new imaging techniques, we aimed to investigate their use for the detection of polyps in patients referred for colonoscopy in a large tertiary hospital.

Methods Demographic, endoscopic, and histological data from 1855 consecutive patients undergoing colonoscopy were collected prospectively. Patients were randomly assigned to three endoscopy systems (Fujinon, Olympus, or Pentax) in combination with four modalities: conventional white-light colonoscopy (n = 505), high definition white-light colonoscopy (n = 582), virtual chromoendoscopy (n = 285) and high definition virtual chromoendoscopy (n = 483).

Results The mean adenoma detection rate (ADR) was 34.9 %, and the adenoma per colonoscopy rate (APCR) was 2.1. No significant differences were noted between the three endoscopy systems. Moreover, no differences in ADR or APCR were observed between the four imaging modalities. High definition white-light colonoscopy resulted in a significantly higher detection of sessile serrated adenomas (8.2 % vs. 3.8 %; P < 0.01) and adenocarcinomas (2.6 % vs. 0.5 %; P < 0.05) compared with the conventional procedure.

Conclusions No significant differences in ADR or APCR between different endoscopy systems, high definition, and/or virtual chromoendoscopy could be observed in routine colonoscopies in the general population. High definition endoscopy was associated with a significantly higher detection rate of serrated adenomas and adenocarcinomas.

Fig. e1, Table e3, e5–e7