Trimodal endoscopic imaging for the detection and differentiation of colorectal adenomas: a prospective single-centre clinical evaluation
| Autor: | Maria Antonia Bianco, Stefano Sansone, Gianluca Rotondano, Costantino Meucci, Antonio Prisco, Maria Lucia Garofano, Livio Cipolletta |
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| Rok vydání: | 2011 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Light Colonoscopy High resolution Fluorescence Statistics Nonparametric Endoscopic imaging medicine Humans False Negative Reactions Aged Narrow-band imaging medicine.diagnostic_test business.industry Gastroenterology Middle Aged medicine.disease Autofluorescence Single centre Female Radiology Colorectal Neoplasms business Clinical evaluation |
| Zdroj: | International Journal of Colorectal Disease. 27:331-336 |
| ISSN: | 1432-1262 0179-1958 |
| Popis: | The purpose of this study is to evaluate an endoscopic trimodal imaging (ETMI) system (high resolution, autofluorescence, and NBI) in the detection and differentiation of colorectal adenomas.A prospective randomised trial of tandem colonoscopies was carried out using the Olympus XCF-FH260AZI system. Each colonic segment was examined twice for lesions, once with HRE and once with AFI, in random order per patient. All detected lesions were assessed with NBI for pit pattern and with AFI for colour. All lesions were removed and sent for histology. Any lesion identified on the second examination was considered as missed by the first examination. Outcome measures are adenoma miss rates of AFI and HRE, and diagnostic accuracy of NBI and AFI for differentiating neoplastic from non-neoplastic lesions.Ninety-four patients underwent colonoscopy with ETMI (47 in each group). Among 47 patients examined with AFI first, 31 adenomas in 15 patients were detected initially [detection rate 0.66 (0.52-0.75)]. Subsequent HRE inspection identified six additional adenomas. Among 47 patients examined with HRE first, 29 adenomas in 14 patients were detected initially [detection rate 0.62 (0.53-0.79)]. Successive AFI yielded seven additional adenomas. Adenoma miss rates of AFI and HRE were 14% and 16.2%, respectively (p = 0.29). Accuracy of AFI alone for differentiation was lower than NBI (63% vs. 80%, p 0.001). Combined use of AFI and NBI achieved improved accuracy for differentiation (84%), showing a trend for superiority compared with NBI alone (p = 0.064).AFI did not significantly reduce the adenoma miss rate compared with HRE. AFI alone had a disappointing accuracy for adenoma differentiation, which could be improved by combination of AFI and NBI. |
| Databáze: | OpenAIRE |
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