title: High-definition with i-Scan gives comparable accuracy for detecting colonic lesions by non-expert and expert endoscopists.
abstract: BACKGROUND
  Lesion detection rate during colonoscopy may be influenced by the endoscopist's experience. EPK-i system colonoscopy (i-Scan) can improve mucosal and vascular visualization for detecting lesions.
  
  
  OBJECTIVE
  To compare mucosal lesions detection rate and the withdrawal time of the instrument among non-expert and expert endoscopists.
  
  
  METHODS
  Colonoscopy records of all consecutive patients undergoing first HD+ with i-Scan- or SWL-equipped colonoscopy for colorectal cancer screening over a twelve-month period were evaluated, in a "post hoc" analysis.
  
  
  RESULTS
  542 colonoscopies (389 HD+ with i-Scan; 153 SWL): expert and non-expert endoscopists did respectively 272 and 117 HD+ with i-Scan and 83 and 70 SWL colonoscopies. Expert endoscopists did more i-Scan colonoscopies than non-experts (p=0.006). In the SWL procedures, the experts detected mucosal lesions in more colonoscopies than non-experts (61/22 vs. 23/47, p=0.0001) and found a significantly higher mean number of lesions (1.34 vs. 0.47; p=0.0001). Experts detected more or less the same mean number of lesions with both imaging techniques, while among non-experts detection with HD+ with i-Scan was significantly better than with SWL imaging (1.39 vs. 0.47; p=0.0001).
  
  
  CONCLUSIONS
  HD+ with i-Scan imaging enables less skilled endoscopists to achieve results comparable to those of experienced ones in detecting mucosal lesions.
authors: Division of Gastroenterology and Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy. testoni.pieralberto@hsr.it
authors: Pier Alberto
authors: PA
authors: Testoni
authors: Chiara
authors: C
authors: Notaristefano
authors: Milena
authors: M
authors: Di Leo
authors: Cristian
authors: C
authors: Vailati
authors: Giorgia
authors: G
authors: Mazzoleni
authors: Edi
authors: E
authors: Viale
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000295:instrumentation*; D055088:Early Detection of Cancer; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008503:Medical Staff / Q000592:standards* / Q000706:statistics & numerical data; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors