Document Detail


Recognition and characterization of small colonic neoplasia with high-definition colonoscopy using i-Scan is as precise as chromoendoscopy.
MedLine Citation:
PMID:  19473893     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The EPKi system (Pentax, Japan) enables resolution above HDTV. Aim of the study was to test the efficacy of HD+ alone and with the new post-processing digital filter i-Scan or chromoendoscopy (Methylene blue 0.1%) in screening for colorectal cancer. We focused on lesions less than 5 mm as a surrogate marker for the optical possibilities of the EPKi system. METHODS: The last 30 cm of the colon in a screening population were inspected with HD+ alone, in combination with i-Scan (2:1 randomisation) and subsequently with chromoendoscopy. All lesions were characterized and targeted biopsies were performed. RESULTS: i-Scan augmented in 69 patients the identification of lesions from 176 to 335 (p<0.001) and chromoendoscopy to 646 (p<0.001). The additional lesions were mainly flat (type IIb, 74%), which were only recognized using i-Scan or chromoendoscopy. The amount of neoplasias was not significantly different (HD+: 5, i-Scan: 11, Chromoendoscopy: 11), but all could correctly be predicted using i-Scan or chromoendoscopy. CONCLUSIONS: HD+ colonoscopy with and without i-Scan unmask a plethora of small lesions but chromoendoscopy can even advance the number. However, i-Scan was able to predict neoplasia as precisely as chromoendoscopy and might shortly replace chromoendoscopy as a more time efficient tool.
Authors:
A Hoffman; C Kagel; M Goetz; A Tresch; J Mudter; S Biesterfeld; P R Galle; M F Neurath; R Kiesslich
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-05-26
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  42     ISSN:  1878-3562     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  45-50     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Affiliation:
I. Med. Clinic, Johannes Gutenberg University Mainz, Germany. AHoff66286@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adenoma / pathology*
Colonic Polyps / pathology*
Colonoscopy / methods*
Colorectal Neoplasms / pathology*
Female
Humans
Hyperplasia / pathology
Image Interpretation, Computer-Assisted / instrumentation,  methods*
Male
Methylene Blue / diagnostic use
Middle Aged
Chemical
Reg. No./Substance:
61-73-4/Methylene Blue
Comments/Corrections
Comment In:
Dig Liver Dis. 2010 Jan;42(1):18-9   [PMID:  19955024 ]

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