Efficacy of computed virtual chromoendoscopy on colorectal cancer screening: a prospective, randomized, back-to-back trial of Fuji Intelligent Color Enhancement versus conventional colonoscopy to compare adenoma miss rates.
BACKGROUND
Colonoscopy is the criterion standard for screening of colorectal neoplasms. Nonetheless, a substantial miss rate with conventional, white-light colonoscopy (WL) remains a challenge.


OBJECTIVE
To assess whether Fuji Intelligent Color Enhancement (FICE) can detect more adenomas than WL in screening colonoscopy.


METHODS
Prospective, randomized trial of tandem colonoscopy adjusted for withdrawal time and lavage effect.


METHODS
Seoul National University Hospital Healthcare System Gangnam Center, Korea.


METHODS
This study involved 359 average-risk adults undergoing screening colonoscopy.


METHODS
Patients were randomized to the first withdrawal with either FICE (FICE-WL group) or WL (WL-FICE group).


METHODS
The primary end point measure was the difference in adenoma miss rates, and the secondary outcome measure was the adenoma detection rate.


RESULTS
We enrolled 359 patients (mean age 50.6 years, male 66.9%) and randomly assigned 181 to the WL-FICE group and 178 to the FICE-WL group. The number of adenomas detected by FICE and WL was 123 and 107, respectively. The adenoma miss rate with FICE showed no significant difference compared with that of WL (6.6% vs 8.3%, P = .59). Characteristics of lesions missed by use of FICE were similar to those missed by use of WL; 93% of overall missed polyps were < or =5 mm, and none were > or =1 cm. All missed adenomas were low grade and nonpedunculated. There was no significant difference between FICE and WL in adenoma detection rate (mean 0.64 vs 0.55 per patient, P = .65) nor percentage of patients with > or =1 adenoma (33.7% vs 30.4%, P = .74).


CONCLUSIONS
Single-center study.


CONCLUSIONS
FICE at screening colonoscopy did not improve the adenoma miss rate or detection rate compared with WL.
Chung
Su Jin
SJ
Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.
Kim
Donghee
D
Song
Ji Hyun
JH
Park
Min Jung
MJ
Kim
Young Sun
YS
Kim
Joo Sung
JS
Jung
Hyun Chae
HC
Song
In Sung
IS
D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014584:User-Computer Interface; D014741:Video Recording / Q000379:methods*