Endoscopy 2018; 50(04): S29
DOI: 10.1055/s-0038-1637112
ESGE Days 2018 oral presentations
20.04.2018 – Colon: Improving characterization
Georg Thieme Verlag KG Stuttgart · New York

DIFFERENTIATION BETWEEN NEOPLASTIC AND NON-NEOPLASTIC DIMINUTIVE COLORECTAL POLYPS WITH FUJINON BLUE LIGHT IMAGING ELECTRONIC CHROMOENDOSCOPY WITH AND WITHOUT OPTICAL MAGNIFICATION – A RANDOMIZED, PROSPECTIVE, MULTICENTER TRIAL

M Szalai
1   Endo-Kapszula Endoscopy Unit, Székesferhérvár, Hungary
,
L Oczella
1   Endo-Kapszula Endoscopy Unit, Székesferhérvár, Hungary
,
Z Dubravcsik
2   Bács-Kiskun County Teaching Hospital, OMCH Endoscopy Unit, Kecskemét, Hungary
,
A Szepes
2   Bács-Kiskun County Teaching Hospital, OMCH Endoscopy Unit, Kecskemét, Hungary
,
P Miheller
3   1st and 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
L Madácsy
1   Endo-Kapszula Endoscopy Unit, Székesferhérvár, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Real-time, optical differentiation between neoplastic and non-neoplastic diminutive colorectal polyps is essential during colonoscopy. While adenomas are neoplastic, therefore require polypectomy and histology, hyperplastic polyps never turn malignant and in the future they may be discharged after endoscopic therapy. The aim of our prospective, randomized, multicenter study was to assess the diagnostic accuracy of Fujinon blue light imaging (BLI) electronic chromoendoscopy in the differentiation of neoplastic and non-neoplastic diminutive colorectal polyps.

Methods:

Patients with at least one histologically verified subcentimetric polyp were included. Picture of each polyp with and without 50x optical zoom at standard white-light (WLI), and with BLI were recorded and stored into an anonymized database. Once the video-library was completed, each of our 5 colonoscopic experts independently and randomly reviewed all of the pictures with a standardized, electronic, web based questionnaire. Experts assessed each lesion as neoplastic or non-neoplastic, with a degree of confidence (VAS). The overall diagnostic efficacy with BLI zoom was compared to WLI non-zoom technology.

Results:

Up till now 108 polyps were enrolled. All of the detected polyps were endoscopically removed and histologically analyzed and this regarded as gold standard. The overall diagnostic sensitivity, specificity, accuracy, PPV and NPV to differentiate between adenomatous and hyperplastic lesions were as follows: 67,11%; 79,96%; 71,29%; 89,36% and 60,63% with WLI non-zoom, 84,16%; 74,72%; 81,02%; 87,26% and 70,09% with WLI zoom, 78,08%; 85,71%; 80,55%; 92,01% and 65,76% with BLI non-zoom versus 92,57%; 72,06%; 86,11%; 87,86% and 81,48% with BLI zoom technology, respectively. BLI zoom significantly improved our confidence rate expressed on VAS.

Conclusions:

The new electronic chromoendoscopic with Fujinon Eluxeo BLI combined with optical zoom magnification significantly improved the accuracy of the histological prediction on neoplastic and non-neoplastic lesions as compared to WLI non zoom HD endoscopy. (Study was supported by ECT grant GINOP 2.1.1.-15 – 2015 – 00128)