title: High-definition endoscopy with i-Scan for evaluation of small colon polyps: the HiSCOPE study.
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.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Single academic hospital.
  
  
  METHODS
  Patients undergoing bowel cancer screening colonoscopy.
  
  
  METHODS
  In vivo assessment of all polyps <10 mm by using HDWL and i-Scan image enhancement.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  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. (
  
  
  BACKGROUND
  NCT01761279.).
authors.affiliation: Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom.
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Basford
authors.affiliation: Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom.
authors.forename: Gaius
authors.initials: G
authors.lastname: Longcroft-Wheaton
authors.affiliation: University of Portsmouth, Portsmouth, United Kingdom.
authors.forename: Bernie
authors.initials: B
authors.lastname: Higgins
authors.affiliation: Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Bhandari
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies
keywords: AGA; ASGE; American Gastroenterological Association; American Society for Gastrointestinal Endoscopy; BSG; British Society of Gastroenterology; CE; DCP; FICE; Fujinon intelligent color enhancement; HD; HDWL; NBI; PIVI; Preservation and Incorporation of Valuable Endoscopic Interventions; SCP; SE; TE; contrast enhancement; diminutive colon polyp; high-definition; high-definition white-light; narrow-band imaging; small colon polyp; surface enhancement; tone enhancement