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4 results on '"TANDEM COLONOSCOPY"'

1. G-EYE colonoscopy is superior to standard colonoscopy for increasing adenoma detection rate

Author

Jakob Hendel, Mati Shnell, Johannes W. Rey, Helmut Neumann, Shmuel Rochberger, Rogier de Ridder, Daniel Teubner, Seth A. Gross, Meir Mizrahi, Alexander Vilkin, Michael Yair, Yuri Brachman, Silvia Sanduleanu-Dascalescu, Armita Armina Abedi, Eran Israeli, Shaul Yaari, John Gásdal Karstensen, Chiara Notaristefano, Beni Shpak, Peter Thielsen, Arthur Hoffman, Harold Jacob, Menachem Moshkowitz, Amit Maliar, D. Nageshwar Reddy, Martin Goetz, Pier Alberto Testoni, Julie Isabelle Plougmann, Trine Stigaard, Dov Abramowich, Hrushikesh Chaudhari, Haim Shirin, Sauid Ishaq, Ariel A. Benson, Peter D. Siersema, Michal Braverman, Edi Viale, Stine Sloth, Tiberiu Hershcovici, Nathan Gluck, Shay Matalon, Roel M M Bogie, Ralf Kiesslich, Amir Waizbard, Eyal Shachar, Peter Vilmann, Mark Pochapin, Roman Simantov, Julia Epshtein, Eduard Tsvang, Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), Promovendi ODB, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Shirin, H., Shpak, B., Epshtein, J., Karstensen, J. G., Hoffman, A., de Ridder, R., Testoni, P. A., Ishaq, S., Reddy, D. N., Gross, S. A., Neumann, H., Goetz, M., Abramowich, D., Moshkowitz, M., Mizrahi, M., Vilmann, P., Rey, J. W., Sanduleanu-Dascalescu, S., Viale, E., Chaudhari, H., Pochapin, M. B., Yair, M., Shnell, M., Yaari, S., Hendel, J. W., Teubner, D., Bogie, R. M. M., Notaristefano, C., Simantov, R., Gluck, N., Israeli, E., Stigaard, T., Matalon, S., Vilkin, A., Benson, A., Sloth, S., Maliar, A., Waizbard, A., Jacob, H., Thielsen, P., Shachar, E., Rochberger, S., Hershcovici, T., Plougmann, J. I., Braverman, M., Tsvang, E., Abedi, A. A., Brachman, Y., Siersema, P. D., and Kiesslich, R.

Subjects
Male, Colorectal cancer, MULTICENTER, Colonoscopy, Aftercare, Colorectal Neoplasm, Balloon, law.invention, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Adenomatous Polyps, Feces, Hemoglobins, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, Early Detection of Cancer, ENDOCUFF-ASSISTED COLONOSCOPY, medicine.diagnostic_test, Colonoscopes, Incidence (epidemiology), Immunochemistry, Gastroenterology, Adenomatous Polyp, Middle Aged, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Radiology, Colorectal Neoplasms, Human, Adenoma, medicine.medical_specialty, Colonic Polyps, 03 medical and health sciences, COLORECTAL-CANCER INCIDENCE, SURVEILLANCE, medicine, Humans, INTERVAL, Radiology, Nuclear Medicine and imaging, BALLOON COLONOSCOPE, Hemoglobin, TANDEM COLONOSCOPY, Colonoscope, Aged, LESIONS, SOCIETY TASK-FORCE, business.industry, medicine.disease, Clinical trial, Colonic Polyp, MISS RATE, Fece, business
Abstract

Contains fulltext : 205162.pdf (Publisher’s version ) (Open Access) BACKGROUND AND AIMS: Colorectal cancer (CRC) is largely preventable with routine screening and surveillance colonoscopy; however, interval cancers arising from precancerous lesions missed by standard colonoscopy still occur. An increased adenoma detection rate (ADR) has been found to be inversely associated with interval cancers. The G-EYE device includes a reusable balloon integrated at the distal tip of a standard colonoscope, which flattens haustral folds, centralizes the colonoscope's optics, and reduces bowel slippage. The insufflated balloon also aims to enhance visualization of the colon during withdrawal, thereby increasing the ADR. METHODS: In this randomized, controlled, international, multicenter study (11 centers), patients (aged >/=50 years) referred to colonoscopy for screening, surveillance, or changes in bowel habits were randomized to undergo either balloon-assisted colonoscopy by using an insufflated balloon during withdrawal or standard high-definition colonoscopy. The primary endpoint was the ADR. RESULTS: One thousand patients were enrolled between May 2014 and September 2016 to undergo colonoscopy by experienced endoscopists; 803 were finally analyzed (standard colonoscopy n = 396; balloon-assisted colonoscopy n = 407). Baseline parameters were similar in both groups. Balloon-assisted colonoscopy provided a 48.0% ADR compared with 37.5% in the standard colonoscopy group (28% increase; P = .0027). Additionally, balloon-assisted colonoscopy provided for a significant increase in detection of advanced (P = .0033) flat adenomas (P < .0001) and sessile serrated adenomas/polyps (P = .0026). CONCLUSION: Balloon-assisted colonoscopy yielded a higher ADR and increased the detection of advanced, flat, and sessile serrated adenomas/polyps when compared with standard colonoscopy. Improved detection by the G-EYE device could impact the quality of CRC screening by reducing miss rates and consequently reducing interval cancer incidence. (Clinical trial registration number: NCT01917513.).

Published
2019

2. Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia.

Author

Wallace, Michael B., Sharma, Prateek, Bhandari, Pradeep, East, James, Antonelli, Giulio, Lorenzetti, Roberto, Vieth, Micheal, Speranza, Ilaria, Spadaccini, Marco, Desai, Madhav, Lukens, Frank J., Babameto, Genci, Batista, Daisy, Singh, Davinder, Palmer, William, Ramirez, Francisco, Palmer, Rebecca, Lunsford, Tisha, Ruff, Kevin, and Bird-Liebermann, Elizabeth

Abstract

Artificial intelligence (AI) may detect colorectal polyps that have been missed due to perceptual pitfalls. By reducing such miss rate, AI may increase the detection of colorectal neoplasia leading to a higher degree of colorectal cancer (CRC) prevention. Patients undergoing CRC screening or surveillance were enrolled in 8 centers (Italy, UK, US), and randomized (1:1) to undergo 2 same-day, back-to-back colonoscopies with or without AI (deep learning computer aided diagnosis endoscopy) in 2 different arms, namely AI followed by colonoscopy without AI or vice-versa. Adenoma miss rate (AMR) was calculated as the number of histologically verified lesions detected at second colonoscopy divided by the total number of lesions detected at first and second colonoscopy. Mean number of lesions detected in the second colonoscopy and proportion of false negative subjects (no lesion at first colonoscopy and at least 1 at second) were calculated. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted by endoscopist, age, sex, and indication for colonoscopy. Adverse events were also measured. A total of 230 subjects (116 AI first, 114 standard colonoscopy first) were included in the study analysis. AMR was 15.5% (38 of 246) and 32.4% (80 of 247) in the arm with AI and non-AI colonoscopy first, respectively (adjusted OR, 0.38; 95% CI, 0.23–0.62). In detail, AMR was lower for AI first for the ≤5 mm (15.9% vs 35.8%; OR, 0.34; 95% CI, 0.21–0.55) and nonpolypoid lesions (16.8% vs 45.8%; OR, 0.24; 95% CI, 0.13–0.43), and it was lower both in the proximal (18.3% vs 32.5%; OR, 0.46; 95% CI, 0.26–0.78) and distal colon (10.8% vs 32.1%; OR, 0.25; 95% CI, 0.11–0.57). Mean number of adenomas at second colonoscopy was lower in the AI-first group as compared with non-AI colonoscopy first (0.33 ± 0.63 vs 0.70 ± 0.97, P <.001). False negative rates were 6.8% (3 of 44 patients) and 29.6% (13 of 44) in the AI and non-AI first arms, respectively (OR, 0.17; 95% CI, 0.05–0.67). No difference in the rate of adverse events was found between the 2 groups. AI resulted in an approximately 2-fold reduction in miss rate of colorectal neoplasia, supporting AI-benefit in reducing perceptual errors for small and subtle lesions at standard colonoscopy. ClinicalTrials.gov , Number: NCT03954548. When the endoscopist is assisted by artificial intelligence, the risk of missing colorectal neoplasia decreased substantially, reassuring a better stratification of the neoplastic risk of the individual patient, and a higher degree of colorectal cancer prevention. [ABSTRACT FROM AUTHOR]

Published
2022
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3. Update on the role of chromoendoscopy in colonoscopic surveillance of patients with Lynch syndrome

Subjects
colorectal adenoma, ENDOSCOPY, CONSENSUS STATEMENT, NONPOLYPOSIS COLORECTAL-CANCER, HEREDITARY, colorectal cancer diagnosis, image-enhanced endoscopy, WHITE-LIGHT, ADENOMA DETECTION, MISS RATE, hereditary colorectal cancer, MANAGEMENT, TANDEM COLONOSCOPY, INFLAMMATORY-BOWEL-DISEASE
Abstract

(Virtual) chromoendoscopy (CE) improves the detection of small or flat colorectal polyps; however, the evidence in high-risk groups, such as patients of Lynch syndrome (LS), is low. Our aim was to identify and update the evidence for the recommendations regarding surveillance of LS patients, for which the current underlying evidence for use of (virtual) CE was explored. A systematic literature search in PubMed, EMBASE, and Cochrane library was conducted, for all studies comparing (virtual) CE with white-light endoscopy in LS patients. Studies are explained in detail, with special attention to study design, type of (virtual) CE, and timing of polypectomy. Eight studies (409 patients) were included. Five were nonrandomized back-to-back studies and three were randomized back-to-back studies (one parallel and two cross-over design). In six studies the polyps were directly removed, while in two studies polyps were removed only during the second caecal withdrawal. Five studies researched CE with indigo carmine and three studies investigated virtual CE. Due to the heterogeneity between studies, no statistical analysis could be performed. There was a large variety in study design, timing of polypectomy, different (virtual) CE techniques and the patients that were included. Based on current literature, no firm conclusions can be drawn with respect to the additional value of (virtual) CE in the surveillance of patients with LS. However, training of endoscopists in detection and removal of nonpolypoid colorectal neoplasms is crucial, as well as stricter adherence to LS surveillance guidelines in daily clinical practice. For future research, standardization in study designs is needed.

Published
2018

4. Increased colorectal cancer risk during follow-up in patients with hyperplastic polyposis syndrome: a multicentre cohort study

Author

Elisabeth M. H. Mathus-Vliegen, Carel J. M. van Noesel, Monique E. van Leerdam, Jan J. Koornstra, Liselotte P. van Hest, Karam S. Boparai, Paul Fockens, Martin Houben, Evelien Dekker, Annemieke Cats, Fokko M. Nagengast, Faculteit der Geneeskunde, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Gastroenterology & Hepatology, Neurosciences, Clinical Genetics, Human genetics, CCA - Innovative therapy, Gastroenterology and Hepatology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, and Pathology

Subjects
Adult, Male, medicine.medical_specialty, Colorectal cancer, Colon Adenoma, COLONIC POLYPS, Colonoscopy, NEOPLASIA, SESSILE SERRATED ADENOMAS, Gastroenterology, CLASSIFICATION, Chromoendoscopy, SDG 3 - Good Health and Well-being, Internal medicine, medicine, CHROMOENDOSCOPY, Humans, Cumulative incidence, Risk factor, TANDEM COLONOSCOPY, DNA METHYLATION, neoplasms, Aged, Netherlands, Hyperplasia, medicine.diagnostic_test, Hereditary cancer and cancer-related syndromes [ONCOL 1], Intestinal Polyposis, business.industry, PATHWAYS, Syndrome, Middle Aged, Prognosis, medicine.disease, digestive system diseases, PREVALENCE, Hyperplastic Polyp, INDIGOCARMINE, Disease Progression, Female, Colorectal Neoplasms, Epidemiologic Methods, business, Cohort study
Abstract

Contains fulltext : 88068.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: Patients with hyperplastic polyposis syndrome (HPS) receive endoscopic surveillance to prevent malignant progression of polyps. However, the optimal treatment and surveillance protocol for these patients is unknown. The aim of this study was to describe the clinical and pathological features of a large HPS cohort during multiple years of endoscopic surveillance. METHODS: Databases were searched for patients with HPS, who were analysed retrospectively. Endoscopy reports and histopathology reports were collected to evaluate frequency of endoscopic surveillance and to obtain information regarding polyp and the presence of colorectal cancer (CRC). RESULTS: In 77 patients with HPS, 1984 polyps were identified during a mean follow-up period of 5.6 years (range: 0.5-26.6). In 27 (35%) patients CRC was detected of which 22 (28.5%) at initial endoscopy. CRC was detected during surveillance in five patients (cumulative incidence: 6.5%) after a median follow-up time of 1.3 years and a median interval of 11 months. Of these interval CRCs, 4/5 were detected in diminutive serrated polyps (range: 4-16 mm). The cumulative risk of CRC under surveillance was 7% at 5 years. At multivariate logistic regression, an increasing number of hyperplastic polyps (OR 1.05, p=0.013) and serrated adenomas (OR 1.09, p=0.048) was significantly associated with CRC presence. CONCLUSIONS: HPS patients undergoing endoscopic surveillance have an increased CRC risk. The number of serrated polyps is positively correlated with the presence of CRC in HPS, thus supporting a 'serrated pathway' to CRC. To prevent malignant progression, adequate detection and removal of all polyps seems advisable. If this is not feasible, surgical resection should be considered. 01 augustus 2010

Published
2010

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