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  • Title: High-definition endoscopy with i-Scan for evaluation of small colon polyps: the HiSCOPE study.
    Author: Basford PJ, Longcroft-Wheaton G, Higgins B, Bhandari P.
    Journal: Gastrointest Endosc; 2014 Jan; 79(1):111-8. PubMed ID: 23871094.
    Abstract:
    BACKGROUND: Traditional white-light endoscopy cannot reliably distinguish between small (<10 mm) adenomatous and hyperplastic colon polyps. High-definition white-light (HDWL) endoscopy and i-Scan may improve in vivo characterization of small colon polyps. OBJECTIVE: To compare HDWL endoscopy and HDWL plus i-Scan for the assessment of small colon polyps and to measure performance against the American Society for Gastrointestinal Endoscopy (ASGE) thresholds for assessment of diminutive colon polyps. DESIGN: Prospective cohort study. SETTING: Single academic hospital. PATIENTS: Patients undergoing bowel cancer screening colonoscopy. INTERVENTION: In vivo assessment of all polyps <10 mm by using HDWL and i-Scan image enhancement. MAIN OUTCOME MEASUREMENTS: The primary outcome measure was overall diagnostic accuracy of in vivo assessment of colon polyps <10 mm. Secondary outcome measures were sensitivity and specificity for adenomatous histology, negative predictive value for adenomatous histology of diminutive rectosigmoid polyps, and accuracy of prediction of polyp surveillance intervals. RESULTS: A total of 209 polyps in 84 patients were included. There were no significant differences between HDWL endoscopy and i-Scan in characterization of polyps <10 mm (accuracy 93.3% vs 94.7%; P = 1.00; sensitivity 95.5% vs 97.0%; P = .50; specificity 89.3% vs 90.7%; P = 1.00). The negative predictive value for adenomatous histology of diminutive rectosigmoid polyps was 100% with both HDWL endoscopy and i-Scan. U.K. and U.S. polyp surveillance intervals were predicted with 95.2% accuracy with HDWL endoscopy and 97.2% accuracy with i-Scan. LIMITATIONS: Single-center study. CONCLUSION: HDWL endoscopy may be as accurate as HDWL with i-Scan image enhancement for the in vivo characterization of small colon polyps. Both modalities fulfil the ASGE performance thresholds for the assessment of diminutive colon polyps. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01761279.).
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