Sa1994 CAN NEW IMAGE-ENHANCING TECHNOLOGIES IMPROVE ADENOMA DETECTION RATES IN CANCER SCREENING COLONOSCOPIES? A RANDOMIZED CLINICAL TRIAL.

Recent studies have shown that laser colored imaging (LCI) and blue laser imaging (BLI) may be useful in raising adenoma detection rates when compared to white light imaging (WLI). Our aim was to investigate if these new image-enhancing technologies can improve adenoma detection rates in cancer screening colonoscopies. Average-risk patients were randomized in 3 groups: WLI, bright-mode BLI (b-BLI) and LCI for colorectal cancer screening colonoscopy. The study was conducted in 2 digestive endoscopy units by 3 different colonoscopists using EC-L590ZW video endoscopes with VP-4450HD processors and LL-4450 light sources. A total of 168 patients (60.7% women and 39.3% men) were included, with an average of 58.3 years, varying between 43 and 81 years. There was no statistical difference based on patients' age, sex and Boston bowel preparation scale between the 3 colonoscopists. The general adenoma detection rate was 60.1%, with no statistical difference between colonoscopists, but a significant one between groups: 55.5% in WLI, 55.5% in b-BLI and 68.3% in LCI (p=0.0272). The average number of adenomas per patient was 1.06 using WLI, 1.07 using b-BLI and 1.53 using LCI (p=0.0217). The average colonoscope withdrawal time was 11'17” in WLI, 11'57” in b-BLI and 12'28” in LCI, which was only statistically significant when comparing WLI vs. LCI (p=0,049). Although all 3 groups were similar at finding lesions ≤ 5mm in size, our study showed that the LCI group had better flat lesion detection rates. There was a higher adenoma detection rate in the LCI group compared to WLI and b-BLI. Furthermore, the number of adenomas found per patient was also higher when using LCI. Although there was a marginal statistical difference regarding the withdrawal time between the LCI and WLI groups, it does not completely justify the performance gap between the two image modes.Figure 2lesion with LCI modeView Large Image Figure ViewerDownload Hi-res image Download (PPT)