Detection and characterization of colorectal polyps using high-definition white light and i-Scan: Evidence-based
Pradeep Bhandari1, Sreedhari Thayalasekaran1, Ralf Keisslich2
1Portsmouth Hospitals NHS trust, Portsmouth, UK.
United European Gastroenterology Journal
|August 8, 2018
Summary
High-definition white light (HDWL) with i-Scan enhances colorectal neoplasm detection and diagnosis. While effective in expert hands, i-Scan requires training for optimal performance and has diagnostic capabilities similar to other advanced imaging techniques.
Area of Science:
- Gastroenterology and Endoscopy
- Medical Imaging and Diagnostics
- Colorectal Cancer Screening
Background:
- i-Scan is an image enhancement technology providing improved visualization of mucosal and vascular details.
- Accurate detection and diagnosis of colorectal neoplasms are crucial for effective patient management.
Purpose of the Study:
- To establish evidence-based statements on the utility of high-definition white light (HDWL) and i-Scan in colorectal neoplasm detection and diagnosis.
- To achieve expert consensus on the role of these technologies in clinical practice.
Main Methods:
- A modified Delphi process involving expert consensus was employed.
- Evidence-based statements were developed and voted upon, requiring over 80% agreement for consensus.
- The focus was on the application of HDWL and i-Scan for colorectal neoplasms.
Main Results:
- HDWL is recommended over standard definition (SD) for colorectal neoplasm detection and diagnosis.
- HDWL colonoscopy with i-Scan demonstrated improved polyp and adenoma detection rates compared to SD colonoscopy.
- HDWL plus i-Scan showed superiority for optical diagnosis of colorectal neoplasms, meeting ASGE PIVI standards in expert hands but not in non-expert hands, indicating a learning curve and need for training. Its performance is comparable to NBI and FICE.
Conclusions:
- Consensus was reached on seven statements regarding the use of HDWL and i-Scan for colorectal neoplasm detection and diagnosis.
- HDWL with i-Scan offers significant advantages, particularly in experienced endoscopists' hands, for improving diagnostic accuracy.
- Systematic training is essential for optimizing the benefits of i-Scan in optical diagnosis.
Keywords:
coloncolonoscopycolorectal neoplasmcolorectal polypendoscopic diagnosisi-Scanimage-enhanced endoscopyMore Related Videos
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