Randomized Trial of Hood With or Without Wing Attachment-Assisted Colonoscopy With Linked Color Imaging and...

Area of Science:

• Gastroenterology
• Endoscopic technology
• Cancer screening

Background:

• Computer-aided detection (CADe) and linked color imaging (LCI) show promise for improving adenoma detection rates (ADRs) during colonoscopies.
• The comparative effectiveness of CADe and LCI with different colonoscope tip hoods (Endo-Wing vs. transparent) is not well-established.

Purpose of the Study:

• To compare the adenoma detection rate (ADR) between Endo-Wing-assisted colonoscopy with LCI and CADe (ELC) and transparent hood-assisted colonoscopy with LCI and CADe (TLC).
• To evaluate secondary outcomes including polyp detection rate, adenomas per colonoscopy, and procedural parameters.

Main Methods:

• A single-center, non-blinded prospective randomized controlled trial involving 800 patients undergoing colonoscopy.
• Participants were randomized into two groups: ELC (n=400) or TLC (n=400).
• Primary outcome was ADR; secondary outcomes included polyp detection and procedural parameters.

Main Results:

• The ELC group showed a significantly higher ADR (58.00%) than the TLC group (39.75%; P < 0.001).
• ELC also resulted in higher polyp detection rates (61.25% vs. 45.75%; P < 0.001) and more adenomas per colonoscopy (1.17 vs. 0.73; P < 0.001).
• This superiority was consistent for both expert and trainee endoscopists and particularly evident for small (≤5 mm), sessile, and flat adenomas.

Conclusions:

• Endo-Wing-assisted colonoscopy with LCI and CADe (ELC) significantly improves ADR compared to the transparent hood (TLC) approach.
• The ELC method is particularly effective in detecting diminutive and sessile adenomas.
• The consistent benefits across different endoscopist experience levels suggest broad clinical applicability of the ELC technique.