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Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps.

Publication ,  Journal Article
Chan, JL; Lin, L; Feiler, M; Wolf, AI; Cardona, DM; Gellad, ZF
Published in: World journal of gastroenterology : WJG
November 2012

OBJECTIVE: To evaluate accuracy of in vivo diagnosis of adenomatous vs non-adenomatous polyps using i-SCAN digital chromoendoscopy compared with high-definition white light. METHODS: This is a single-center comparative effectiveness pilot study. Polyps (n = 103) from 75 average-risk adult outpatients undergoing screening or surveillance colonoscopy between December 1, 2010 and April 1, 2011 were evaluated by two participating endoscopists in an academic outpatient endoscopy center. Polyps were evaluated both with high-definition white light and with i-SCAN to make an in vivo prediction of adenomatous vs non-adenomatous pathology. We determined diagnostic characteristics of i-SCAN and high-definition white light, including sensitivity, specificity, and accuracy, with regards to identifying adenomatous vs non-adenomatous polyps. Histopathologic diagnosis was the gold standard comparison. RESULTS: One hundred and three small polyps, detected from forty-three patients, were included in the analysis. The average size of the polyps evaluated in the analysis was 3.7 mm (SD 1.3 mm, range 2 mm to 8 mm). Formal histopathology revealed that 54/103 (52.4%) were adenomas, 26/103 (25.2%) were hyperplastic, and 23/103 (22.3%) were other diagnoses include "lymphoid aggregates", "non-specific colitis," and "no pathologic diagnosis." Overall, the combined accuracy of endoscopists for predicting adenomas was identical between i-SCAN (71.8%, 95%CI: 62.1%-80.3%) and high-definition white light (71.8%, 95%CI: 62.1%-80.3%). However, the accuracy of each endoscopist differed substantially, where endoscopist A demonstrated 63.0% overall accuracy (95%CI: 50.9%-74.0%) as compared with endoscopist B demonstrating 93.3% overall accuracy (95%CI: 77.9%-99.2%), irrespective of imaging modality. Neither endoscopist demonstrated a significant learning effect with i-SCAN during the study. Though endoscopist A increased accuracy using i-SCAN from 59% (95%CI: 42.1%-74.4%) in the first half to 67.6% (95%CI: 49.5%-82.6%) in the second half, and endoscopist B decreased accuracy using i-SCAN from 100% (95%CI: 80.5%-100.0%) in the first half to 84.6% (95%CI: 54.6%-98.1%) in the second half, neither of these differences were statistically significant. CONCLUSIONS: i-SCAN and high-definition white light had similar efficacy predicting polyp histology. Endoscopist training likely plays a critical role in diagnostic test characteristics and deserves further study.

Duke Scholars

Published In

World journal of gastroenterology : WJG

DOI

ISSN

1007-9327

Publication Date

November 2012

Volume

18

Issue

41

Start / End Page

5905 / 5911

Related Subject Headings

  • Prospective Studies
  • Predictive Value of Tests
  • Pilot Projects
  • North Carolina
  • Middle Aged
  • Male
  • Linear Models
  • Light
  • Humans
  • Gastroenterology & Hepatology
 

Citation

APA
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ICMJE
MLA
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Chan, J. L., Lin, L., Feiler, M., Wolf, A. I., Cardona, D. M., & Gellad, Z. F. (2012). Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps. World Journal of Gastroenterology : WJG, 18(41), 5905–5911. https://doi.org/10.3748/wjg.v18.i41.5905
Chan, J. L., L. Lin, M. Feiler, A. I. Wolf, D. M. Cardona, and Z. F. Gellad. “Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps.World Journal of Gastroenterology : WJG 18, no. 41 (November 2012): 5905–11. https://doi.org/10.3748/wjg.v18.i41.5905.
Chan JL, Lin L, Feiler M, Wolf AI, Cardona DM, Gellad ZF. Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps. World journal of gastroenterology : WJG. 2012 Nov;18(41):5905–11.
Chan, J. L., et al. “Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps.World Journal of Gastroenterology : WJG, vol. 18, no. 41, Nov. 2012, pp. 5905–11. Manual, doi:10.3748/wjg.v18.i41.5905.
Chan JL, Lin L, Feiler M, Wolf AI, Cardona DM, Gellad ZF. Comparative effectiveness of i-SCAN™ and high-definition white light characterizing small colonic polyps. World journal of gastroenterology : WJG. 2012 Nov;18(41):5905–5911.

Published In

World journal of gastroenterology : WJG

DOI

ISSN

1007-9327

Publication Date

November 2012

Volume

18

Issue

41

Start / End Page

5905 / 5911

Related Subject Headings

  • Prospective Studies
  • Predictive Value of Tests
  • Pilot Projects
  • North Carolina
  • Middle Aged
  • Male
  • Linear Models
  • Light
  • Humans
  • Gastroenterology & Hepatology