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High-definition i-Scan colonoscopy is superior in the detection of diminutive polyps compared with high-definition white light colonoscopy: a prospective randomized-controlled trial

Shan, Jing; Liu, Li; Sun, Xiaobin; Xi, Weidong; Yang, Mei; Tang, Yu; Ren, Chunrong; Shi, Wei

European Journal of Gastroenterology & Hepatology: November 2017 - Volume 29 - Issue 11 - p 1309–1313
doi: 10.1097/MEG.0000000000000976
Original Articles: Endoscopy

Introduction: Recognition of flat and small neoplastic lesions by colonoscopy is still challenging. High-definition (HD) i-Scan colonoscopy is a promising technique to maximize the sensitivity of colonoscopy; however, whether i-Scan can increase the detection rate of polyps is still unclear. The aim of this study was to prospectively compare HD i-Scan colonoscopy with HD colonoscopy for the detection rate of polyps in routine practice.

Materials and methods: A total of 449 patients who underwent total colonoscopy for the first time were randomized in a 1 : 1 ratio to undergo HD+i-Scan colonoscopy or HD colonoscopy. Detected colorectal polyps were judged according to type, location, and size. The primary endpoint was the detection rate and the total number of polyps.

Results: The number of polyps identified in the HD+i-Scan group was significantly higher than that in the HD group (P=0.041), and this difference was more obvious for diminutive polyps (P=0.035). The number of patients with at least one polyp was not significantly different between the two groups irrespective of the size or the location. Overall, 268 polyps were removed, 130 in the HD+i-Scan group and 138 in the HD group. Among these, three high-grade intraepithelial neoplasia were found in diminutive polyps.

Conclusion: HD+i-Scan colonoscopy is superior to HD colonoscopy in detecting diminutive polyps on the basis of this prospective randomized-controlled trial.

Department of Gastroenterology, The 3rd People’s Hospital of Chengdu, The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chongqing, China

Corresponding to Xiaobin Sun, MD, #82, Qinglong Street, Qingyang District, Chengdu, Sichuan, China Tel: +86 286 131 8700; e-mail: xbsun1197@163.com

Received June 16, 2017

Accepted August 7, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.