Efficacy of computed virtual chromoendoscopy on colorectal cancer screening: a prospective, randomized, back-to-back trial of Fuji Intelligent Color Enhancement versus conventional colonoscopy to compare adenoma miss rates.

Chung, Su Jin; Kim, Donghee; Song, Ji Hyun; Park, Min Jung; Kim, Young Sun; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung
Gastrointestinal endoscopy
2010Jul ; 72 ( 1 ) :136-42.
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Chung, Su Jin -
Kim, Donghee -
Song, Ji Hyun -
Park, Min Jung -
Kim, Young Sun -
Kim, Joo Sung -
Jung, Hyun Chae -
Song, In Sung -
ABSTRACT
BACKGROUND: Colonoscopy is the criterion standard for screening of colorectal neoplasms. Nonetheless, a substantial miss rate with conventional, white-light colonoscopy (WL) remains a challenge. OBJECTIVE: To assess whether Fuji Intelligent Color Enhancement (FICE) can detect more adenomas than WL in screening colonoscopy. DESIGN: Prospective, randomized trial of tandem colonoscopy adjusted for withdrawal time and lavage effect. SETTING: Seoul National University Hospital Healthcare System Gangnam Center, Korea. PATIENTS: This study involved 359 average-risk adults undergoing screening colonoscopy. INTERVENTION: Patients were randomized to the first withdrawal with either FICE (FICE-WL group) or WL (WL-FICE group). MAIN OUTCOME MEASUREMENTS: The primary end point measure was the difference in adenoma miss rates, and the secondary outcome measure was the adenoma detection rate.

RESULTS: We enrolled 359 patients (mean age 50.6 years, male 66.9%) and randomly assigned 181 to the WL-FICE group and 178 to the FICE-WL group. The number of adenomas detected by FICE and WL was 123 and 107, respectively. The adenoma miss rate with FICE showed no significant difference compared with that of WL (6.6% vs 8.3%, P = .59). Characteristics of lesions missed by use of FICE were similar to those missed by use of WL; 93% of overall missed polyps were < or =5 mm, and none were > or =1 cm. All missed adenomas were low grade and nonpedunculated. There was no significant difference between FICE and WL in adenoma detection rate (mean 0.64 vs 0.55 per patient, P = .65) nor percentage of patients with > or =1 adenoma (33.7% vs 30.4%, P = .74). LIMITATIONS: Single-center study. CONCLUSION: FICE at screening colonoscopy did not improve the adenoma miss rate or detection rate compared with WL. CI - Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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MESH
Adenoma/*diagnosis, Adult, Aged, Colonic Polyps/*diagnosis, Colonoscopy/*methods, Colorectal Neoplasms/*diagnosis, Early Detection of Cancer/*methods, Female, Humans, Image Enhancement/*methods, Image Interpretation, Computer-Assisted/*methods, Intestinal Mucosa/pathology, Male, Middle Aged, Prospective Studies, Republic of Korea, Risk Factors, Sensitivity and Specificity, *User-Computer Interface, Video Recording/*methods
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FICE at screening colonoscopy did not improve the adenoma miss rate or detection rate compared with WL.
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DOI
10.1016/j.gie.2010.01.055
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ICD 03
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