title: Advanced imaging in colonoscopy and its impact on quality.
abstract: Detecting and resecting colonic polyps during endoscopy has been shown to reduce CRC. At the same time, endoscopy has faced substantial technical improvements and continues to undergo major changes. Detection of colorectal neoplasias is facilitated by using high-definition endoscopy, and characterization of lesions is more accurate by using virtual CE. High-definition endoscopy has found widespread use, whereas virtual CE is still more often used in tertiary centers and for high-risk patient groups. Endomicroscopy has opened the door for in vivo histology and functional as well as molecular imaging. Thorough training of the endoscopists is necessary, and redefined reimbursement codes may help make these techniques available in the clinical arena for high-risk patients who are most probable to benefit from the more advanced diagnostic endoscopy techniques. Over recent years, there has also been an increasing push by healthcare payors and providers to improve the quality of healthcare services. The ultimate goal of monitoring quality measures is to improve the overall health of the population and, for colon cancer screening, to reduce the incidence and mortality of colon cancer. However, the development of an appropriate quality measure and ensuring the accuracy of the data on which we base our efforts are among the first challenges that we must meet (Table 1). The continued technologic advancements in colonoscopy and endoscopic imaging may result in improvements in the quality of colonoscopy and should lead to a decrease in the incidence and mortality from colon cancer.
authors.affiliation: Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center, Kansas City, Missouri, USA; Department of Gastroenterology and Hepatology, The University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Gastroenterology, Loyola University Health System, Maywood, Illinois, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.affiliation: Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Wallace
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D004396:Coloring Agents; D055088:Early Detection of Cancer; D006801:Humans; D018613:Microscopy, Confocal; D062048:Narrow Band Imaging; D019984:Quality Indicators, Health Care
chemical_list: D004396:Coloring Agents
keywords: ADR; ASGE; American Society for Gastrointestinal Endoscopy; CAC; CE; CLE; CRC; HDWL; IBD; NBI; SDWL; TER; adenoma detection rate; cap-assisted colonoscopy; chromoendoscopy; colorectal cancer; confocal laser endomicroscopy; high-definition white light; inflammatory bowel disease; narrow-band imaging; standard-definition white light; third eye retroscope