Detection and characterization of colorectal polyps using high-definition white light and i-Scan: Evidence-based consensus recommendations using a modified Delphi process. Issue 5 (June 2018)

• Record Type: Journal Article
• Authors: Bhandari, Pradeep; Thayalasekaran, Sreedhari; Keisslich, Ralf; Bisschops, Raf; Hoffmann, Arthur; Haidry, Rehan; Esteban, Jose; López Viedma, Bartolomé; Godzhello, Elina; Almadi, Majid; Neumann, Helmut; Sanduleanu, Silvia
• Is Part Of: United European Gastroenterology journal. Volume 6:Issue 5(2018)
• Page Start: 748
• Page End: 754
• Publication Date: 2018-06
• Subjects: i-Scan -- colonoscopy -- colorectal neoplasm -- colorectal polyp -- image-enhanced endoscopy -- colon -- endoscopic diagnosis; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640618764531
• Languages: English
• ISSNs: 2050-6406

Abstract

Background: i-Scan is an image enhancement modality, which provides enhanced views of mucosal structures and vascular patterns. Methods: A modified Delphi process was used to develop a series of evidence-based statements on the role of high-definition white light (HDWL) and i-Scan for the detection and diagnosis of colorectal neoplasms. Each statement was voted to achieve consensus (i.e. >80% agreement). Results: Seven proposed statements achieved consensus: (1) HDWL is recommended rather than standard definition (SD) for detection and diagnosis of colorectal neoplasms; (2) HDWL colonoscopy with i-Scan improves polyp and adenoma detection rates when compared with SD colonoscopy; (3) HDWL + i-Scan is superior to HDWL alone for the optical diagnosis of colorectal neoplasms; (4) HDWL + i-Scan in expert hands meets American Society for Gastrointestinal Endoscopy (ASGE) in the Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) standards for optical diagnosis of diminutive neoplasms; (5) HDWL + i-Scan in non-expert hands does not meet ASGE PIVI standards for optical diagnosis of diminutive neoplasms; (6) optical diagnosis of polyps with i-Scan has a learning curve and needs systematic training; and (7) the performance of i-Scan for the in vivo diagnosis of colorectal neoplasms is similar to Narrow Band Imaging (NBI) and Fuji Intelligent Chromo Endoscopy (FICE). Conclusions: Seven proposed statements on the use of HDWL and i-Scan for the detection and diagnosis of colorectal neoplasms achieved consensus.