Does Autofluorescence Imaging Videoendoscopy System Improve the Colonoscopic Polyp Detection Rate?—A Pilot Study

OBJECTIVES: Colonoscopy is considered the gold standard for the detection of colorectal polyps; however, polyps can be missed with conventional white light (WL) colonoscopy. The aim of this pilot study was to evaluate whether a newly developed autofluorescence imaging (AFI) system can detect more colorectal polyps than WL.METHODS: A modified back-to-back colonoscopy using AFI and WL was conducted for 167 patients in the right-sided colon including cecum, ascending and transverse colon by a single experienced colonoscopist. The patient was randomized to undergo the first colonoscopy with either AFI or WL (group A: AFI-WL, group B: WL-AFI). The time needed for both insertion and examination for withdrawal and all lesions detected in the right-sided colon were recorded.RESULTS: Eighty-three patients were randomized to group A and 84 to group B. The total number of polyps detected by AFI and WL colonoscopy was 100 and 73, respectively. The miss rate for all polyps with AFI (30%) was significantly less than that with WL (49%) (P= 0.01).CONCLUSIONS: AFI detects more polyps in the right-sided colon compared to WL colonoscopy.

[1]  Y. Sano,et al.  Efficacy of magnifying chromoendoscopy for the differential diagnosis of colorectal lesions , 2005 .

[2]  E. G. Hahn,et al.  Fluorescence induced with 5-aminolevulinic acid for the endoscopic detection and follow-up of esophageal lesions. , 2001, Gastrointestinal endoscopy.

[3]  S. Sahara,et al.  SUCCESSFUL MANAGEMENT OF METASTASIS‐INDUCED PANCREATITIS BY ENDOSCOPIC PANCREATIC DUCT STENTING IN A CASE OF LARGE CELL LUNG CANCER , 2007 .

[4]  S S Cross,et al.  Detecting diminutive colorectal lesions at colonoscopy: a randomised controlled trial of pan-colonic versus targeted chromoscopy , 2004, Gut.

[5]  B. Veress,et al.  Flat and depressed colorectal tumours in a southern Swedish population: a prospective chromoendoscopic and histopathological study , 2002, Gut.

[6]  H. Tajiri,et al.  The histological basis of detection of adenoma and cancer in the colon by autofluorescence endoscopic imaging. , 1999, Endoscopy.

[7]  Hisao Tajiri,et al.  OPTICAL/DIGITAL CHROMOENDOSCOPY DURING COLONOSCOPY USING NARROW‐BAND IMAGING SYSTEM , 2005 .

[8]  K. Haruma,et al.  Detailed colonoscopy for detecting early superficial carcinoma: recent developments. , 2000, Journal of gastroenterology.

[9]  安達 実樹 Flat Adenoma of the Large Bowel : Re-Evaluation with Special Reference to Central Depression , 2000 .

[10]  R. Kiesslich,et al.  Chromoendoscopy with Indigocarmine Improves the Detection of Adenomatous and Nonadenomatous Lesions in the Colon , 2001, Endoscopy.

[11]  B. Wilson,et al.  Autofluorescence endoscopy: feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology. , 2001, Gastrointestinal endoscopy.

[12]  D. Rex,et al.  170 degrees wide-angle colonoscope: effect on efficiency and miss rates. , 2004, The American journal of gastroenterology.

[13]  Steven Brown,et al.  A prospective clinicopathological and endoscopic evaluation of flat and depressed colorectal lesions in the United Kingdom , 2003, American Journal of Gastroenterology.

[14]  B F Overholt,et al.  Endoscopic fluorescence detection of high-grade dysplasia in Barrett's esophagus. , 1996, Gastroenterology.

[15]  T. Ohkusa,et al.  Diagnostic Performance of Light-Induced Fluorescence Endoscopy for Gastric Neoplasms , 2004, Endoscopy.

[16]  N. Yamanaka,et al.  Optimal route of administration of mixed endothelin receptor antagonist (TAK-044) in liver transplantation , 2000, Journal of Gastroenterology.

[17]  H. Tajiri,et al.  Detection of early gastric cancer by a real-time autofluorescence imaging system. , 2001, Cancer letters.

[18]  A. Zauber,et al.  Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. , 1993 .

[19]  Syed G. Shah,et al.  Total colonic dye-spray increases the detection of diminutive adenomas during routine colonoscopy: a randomized controlled trial. , 2002, Gastrointestinal endoscopy.

[20]  Shinji Tanaka,et al.  Nonpolypoid (flat and depressed) colorectal neoplasms. , 2006, Gastroenterology.

[21]  T J Flotte,et al.  Ultraviolet laser-induced fluorescence of colonic polyps. , 1992, Gastroenterology.

[22]  R M Cothren,et al.  Detection of dysplasia at colonoscopy using laser-induced fluorescence: a blinded study. , 1996, Gastrointestinal endoscopy.

[23]  Douglas K Rex,et al.  170° Wide-Angle Colonoscope: Effect on Efficiency and Miss Rates , 2004, The American Journal of Gastroenterology.

[24]  Noriya Uedo,et al.  DIAGNOSIS OF COLONIC ADENOMAS BY NEW AUTOFLUORESCENCE IMAGING SYSTEM: A PILOT STUDY , 2007 .

[25]  S. Takehana,et al.  Endoscopic Diagnostic System Using Autofluorescence , 1999, Diagnostic and therapeutic endoscopy.

[26]  M. Vatn,et al.  Growth of colorectal polyps: recovery and evaluation of unresected polyps of less than 10 mm, 1 year after detection. , 1994, Scandinavian journal of gastroenterology.

[27]  S. Kudo,et al.  Diagnosis of colorectal tumorous lesions by magnifying endoscopy. , 1996, Gastrointestinal endoscopy.

[28]  Shin-ei Kudo,et al.  Colonoscopic Diagnosis and Management of Nonpolypoid Early Colorectal Cancer , 2000, World Journal of Surgery.

[29]  Douglas K Rex,et al.  High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging. , 2007, Gastroenterology.

[30]  Osamu Kobayashi,et al.  NEWLY DEVELOPED AUTOFLUORESCENCE IMAGING VIDEOSCOPE SYSTEM FOR THE DETECTION OF COLONIC NEOPLASMS , 2005 .

[31]  K. Okazaki,et al.  Efficacy of Total Colonoscopy with a Transparent Cap in Comparison with Colonoscopy without the Cap , 1998, Endoscopy.

[32]  T. Fujii,et al.  Chromoscopy During Colonoscopy , 2001, Endoscopy.

[33]  D. Rex,et al.  Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. , 1997, Gastroenterology.

[34]  E T Stewart,et al.  Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. , 1993, The New England journal of medicine.

[35]  J. Ray,et al.  Usefulness of performing colonoscopy one year after endoscopic polypectomy , 1990, Diseases of the colon and rectum.

[36]  L. Deckelbaum,et al.  Laser-induced fluorescence spectroscopy of human colonic mucosa. Detection of adenomatous transformation. , 1990, Gastroenterology.

[37]  T. Fujii,et al.  Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK , 2000, The Lancet.

[38]  J. Rey,et al.  Does Chromoendoscopy with Structure Enhancement Improve the Colonoscopic Adenoma Detection Rate? , 2006, Endoscopy.

[39]  N. Uedo,et al.  A novel videoendoscopy system by using autofluorescence and reflectance imaging for diagnosis of esophagogastric cancers. , 2005, Gastrointestinal endoscopy.

[40]  Stanley R. Hamilton,et al.  Pathology and genetics of tumours of the digestive system , 2000 .

[41]  Anthony N Kalloo,et al.  Prevalence and distinctive biologic features of flat colorectal adenomas in a North American population. , 2002, Gastroenterology.

[42]  Chi-Yang Chang,et al.  A prospective comparative study of narrow-band imaging, chromoendoscopy, and conventional colonoscopy in the diagnosis of colorectal neoplasia , 2007, Gut.

[43]  D. Rex,et al.  Wide angle colonoscopy with a prototype instrument: impact on miss rates and efficiency as determined by back-to-back colonoscopies , 2003, American Journal of Gastroenterology.

[44]  J. Haringsma,et al.  The Value of Fluorescence Techniques in Gastrointestinal Endoscopy: Better than the Endoscopist's Eye? I: The European Experience , 1998, Endoscopy.