PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series
IntroductionIndigocarmine (IC) and narrow-band imaging have been shown to be effective in the in vivo diagnosis of small colonic polyps. The learning curve for achieving high level of accuracy with a new technology for real-time diagnosis of small colonic polyps has not been determined.MethodsWe aim...
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| description | IntroductionIndigocarmine (IC) and narrow-band imaging have been shown to be effective in the in vivo diagnosis of small colonic polyps. The learning curve for achieving high level of accuracy with a new technology for real-time diagnosis of small colonic polyps has not been determined.MethodsWe aimed to assess the learning curve of a novel electronic in vivo diagnosis technology (Pentax iScan) for an expert endoscopist. Patients presenting for screening colonoscopy through the UK Bowel Cancer Screening Programme were prospectively recruited. All colonoscopies were performed by a single expert endoscopist, with extensive experience in in vivo diagnosis, using Pentax EC-3890Li 1.2 Megapixel HD colonoscopes and EPKi processor. Polyps |
| doi_str_mv | 10.1136/gutjnl-2012-302514d.186 |
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| fullrecord | <record><control><sourceid>proquest_istex</sourceid><recordid>TN_cdi_proquest_journals_1779428622</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4014633271</sourcerecordid><originalsourceid>FETCH-LOGICAL-b1092-78b644c682b029a7b8f9f1e053a1146781906364eb5b8c63cc0fe281a3888ed53</originalsourceid><addsrcrecordid>eNo9kctKxDAUhoMoOF6ewYBbo7m0SepOhhkVvMF4WYY0k44Z06YmrejOjS_qk9hhBlcHDh__uXwAHBF8SgjjZ4u-WzYeUUwoYpjmJJufEsm3wIhkXCJGpdwGI4yJQLnIil2wl9ISYyxlQUYgPrxM0ID_fv-4mdENdA3sXi20H9r3unOhgaGCqdbeQxN8aJyBbfBfbTqHoe9MqG06gd7q2LhmAU0fPyysYqihhl7HhYVtDK01nRv6yUZn0wHYqbRP9nBT98HTdPI4vkI395fX44sbVBJcUCRkybPMcElLTAstSlkVFbE4Z5oMlwlJCswZz2yZl9JwZgyuLJVEMymlnedsHxyvc4cN3nubOrUMfWyGkYoIUWRUckoHCq0plzr7qdroah2_lI5vigsmcnX3PFa3s_zuajq-VLOBp2u-rJf_NMFq5UKtXaiVC7VxoYbnsj8soX5f</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1779428622</pqid></control><display><type>article</type><title>PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series</title><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Basford, P J ; Longcroft-Wheaton, G R ; Bhandari, P</creator><creatorcontrib>Basford, P J ; Longcroft-Wheaton, G R ; Bhandari, P</creatorcontrib><description>IntroductionIndigocarmine (IC) and narrow-band imaging have been shown to be effective in the in vivo diagnosis of small colonic polyps. The learning curve for achieving high level of accuracy with a new technology for real-time diagnosis of small colonic polyps has not been determined.MethodsWe aimed to assess the learning curve of a novel electronic in vivo diagnosis technology (Pentax iScan) for an expert endoscopist. Patients presenting for screening colonoscopy through the UK Bowel Cancer Screening Programme were prospectively recruited. All colonoscopies were performed by a single expert endoscopist, with extensive experience in in vivo diagnosis, using Pentax EC-3890Li 1.2 Megapixel HD colonoscopes and EPKi processor. Polyps <10 mm in size were assessed sequentially using three modalities (1) White light HD endoscopy (WL), (2) Pentax iScan surface and tone enhancement, (3) IC chromoendoscopy. Optical magnification was not used. Predicted histology (non-neoplastic, adenoma, cancer) was recorded for each modality and compared to the final histopathological diagnosis. Results were analysed for sensitivity and specificity for neoplasia, and overall accuracy. To assess any learning effect results were analysed in three sets of 100 consecutive polyps.ResultsA total of 309 polyps were eligible for inclusion in the study. Mean polyp diameter was 4.1 mm, median 3 mm. 133 polyps were in the proximal colon and 176 in the distal colon. 109 polyps were non-neoplastic, 199 were adenomatous and one contained adenocarcinoma. Sensitivity and overall accuracy improved significantly for all three imaging modalities in the 3rd set of polyps as compared to sets 1 and 2 (p<0.05). In Set 3 overall accuracies of 92.7%, 93.6% and 93.6% were achieved with WL, iScan and IC respectively. There were no significant differences in overall accuracy between the three modalities in Set 3. Negative predictive values for adenomatous histology of recto-sigmoid polyps ≤5 mm for the entire study were 96.5%, 93.4% and 98.3% for WL, iScan and IC respectively.Conclusion(1) Even in expert hands there is a significant learning curve for using a new technology for the in vivo diagnosis of small colonic polyps, with improvement in performance over the first 200 polyps assessed. (2) Excellent results can be achieved once the new technology has been mastered. (3) This is the first report of results achieved with high-definition white light endoscopy which are comparable with electronic chromoendoscopy and IC chromoendoscopy.Abstract PWE-186 Table 1WLiScanICSet 1 (Polyps 1–100) Sensitivity0.7880.8680.904 Specificity0.7080.7660.729 Accuracy0.7500.8200.820Set 2 (Polyps 101–200) Sensitivity0.8660.8510.881 Specificity0.7580.7580.788 Accuracy0.8300.8200.850Set 3 (Polyps 201–309) Sensitivity0.9640.9880.976 Specificity0.8080.7690.808 Accuracy0.9270.9360.936Competing interestsNone declared.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2012-302514d.186</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Accuracy ; Adenocarcinoma ; Adenoma ; Cancer screening ; Colon ; Diagnosis ; Endoscopy ; Histology ; Intestine ; Learning ; Medical screening ; Polyps</subject><ispartof>Gut, 2012-07, Vol.61 (Suppl 2), p.A372</ispartof><rights>2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2012 © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gut.bmj.com/content/61/Suppl_2/A372.1.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://gut.bmj.com/content/61/Suppl_2/A372.1.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,23571,27924,27925,77600,77631</link.rule.ids></links><search><creatorcontrib>Basford, P J</creatorcontrib><creatorcontrib>Longcroft-Wheaton, G R</creatorcontrib><creatorcontrib>Bhandari, P</creatorcontrib><title>PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series</title><title>Gut</title><addtitle>Gut</addtitle><description>IntroductionIndigocarmine (IC) and narrow-band imaging have been shown to be effective in the in vivo diagnosis of small colonic polyps. The learning curve for achieving high level of accuracy with a new technology for real-time diagnosis of small colonic polyps has not been determined.MethodsWe aimed to assess the learning curve of a novel electronic in vivo diagnosis technology (Pentax iScan) for an expert endoscopist. Patients presenting for screening colonoscopy through the UK Bowel Cancer Screening Programme were prospectively recruited. All colonoscopies were performed by a single expert endoscopist, with extensive experience in in vivo diagnosis, using Pentax EC-3890Li 1.2 Megapixel HD colonoscopes and EPKi processor. Polyps <10 mm in size were assessed sequentially using three modalities (1) White light HD endoscopy (WL), (2) Pentax iScan surface and tone enhancement, (3) IC chromoendoscopy. Optical magnification was not used. Predicted histology (non-neoplastic, adenoma, cancer) was recorded for each modality and compared to the final histopathological diagnosis. Results were analysed for sensitivity and specificity for neoplasia, and overall accuracy. To assess any learning effect results were analysed in three sets of 100 consecutive polyps.ResultsA total of 309 polyps were eligible for inclusion in the study. Mean polyp diameter was 4.1 mm, median 3 mm. 133 polyps were in the proximal colon and 176 in the distal colon. 109 polyps were non-neoplastic, 199 were adenomatous and one contained adenocarcinoma. Sensitivity and overall accuracy improved significantly for all three imaging modalities in the 3rd set of polyps as compared to sets 1 and 2 (p<0.05). In Set 3 overall accuracies of 92.7%, 93.6% and 93.6% were achieved with WL, iScan and IC respectively. There were no significant differences in overall accuracy between the three modalities in Set 3. Negative predictive values for adenomatous histology of recto-sigmoid polyps ≤5 mm for the entire study were 96.5%, 93.4% and 98.3% for WL, iScan and IC respectively.Conclusion(1) Even in expert hands there is a significant learning curve for using a new technology for the in vivo diagnosis of small colonic polyps, with improvement in performance over the first 200 polyps assessed. (2) Excellent results can be achieved once the new technology has been mastered. (3) This is the first report of results achieved with high-definition white light endoscopy which are comparable with electronic chromoendoscopy and IC chromoendoscopy.Abstract PWE-186 Table 1WLiScanICSet 1 (Polyps 1–100) Sensitivity0.7880.8680.904 Specificity0.7080.7660.729 Accuracy0.7500.8200.820Set 2 (Polyps 101–200) Sensitivity0.8660.8510.881 Specificity0.7580.7580.788 Accuracy0.8300.8200.850Set 3 (Polyps 201–309) Sensitivity0.9640.9880.976 Specificity0.8080.7690.808 Accuracy0.9270.9360.936Competing interestsNone declared.</description><subject>Accuracy</subject><subject>Adenocarcinoma</subject><subject>Adenoma</subject><subject>Cancer screening</subject><subject>Colon</subject><subject>Diagnosis</subject><subject>Endoscopy</subject><subject>Histology</subject><subject>Intestine</subject><subject>Learning</subject><subject>Medical screening</subject><subject>Polyps</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNo9kctKxDAUhoMoOF6ewYBbo7m0SepOhhkVvMF4WYY0k44Z06YmrejOjS_qk9hhBlcHDh__uXwAHBF8SgjjZ4u-WzYeUUwoYpjmJJufEsm3wIhkXCJGpdwGI4yJQLnIil2wl9ISYyxlQUYgPrxM0ID_fv-4mdENdA3sXi20H9r3unOhgaGCqdbeQxN8aJyBbfBfbTqHoe9MqG06gd7q2LhmAU0fPyysYqihhl7HhYVtDK01nRv6yUZn0wHYqbRP9nBT98HTdPI4vkI395fX44sbVBJcUCRkybPMcElLTAstSlkVFbE4Z5oMlwlJCswZz2yZl9JwZgyuLJVEMymlnedsHxyvc4cN3nubOrUMfWyGkYoIUWRUckoHCq0plzr7qdroah2_lI5vigsmcnX3PFa3s_zuajq-VLOBp2u-rJf_NMFq5UKtXaiVC7VxoYbnsj8soX5f</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Basford, P J</creator><creator>Longcroft-Wheaton, G R</creator><creator>Bhandari, P</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>201207</creationdate><title>PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series</title><author>Basford, P J ; Longcroft-Wheaton, G R ; Bhandari, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1092-78b644c682b029a7b8f9f1e053a1146781906364eb5b8c63cc0fe281a3888ed53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Accuracy</topic><topic>Adenocarcinoma</topic><topic>Adenoma</topic><topic>Cancer screening</topic><topic>Colon</topic><topic>Diagnosis</topic><topic>Endoscopy</topic><topic>Histology</topic><topic>Intestine</topic><topic>Learning</topic><topic>Medical screening</topic><topic>Polyps</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Basford, P J</creatorcontrib><creatorcontrib>Longcroft-Wheaton, G R</creatorcontrib><creatorcontrib>Bhandari, P</creatorcontrib><collection>Istex</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Basford, P J</au><au>Longcroft-Wheaton, G R</au><au>Bhandari, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2012-07</date><risdate>2012</risdate><volume>61</volume><issue>Suppl 2</issue><spage>A372</spage><pages>A372-</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>IntroductionIndigocarmine (IC) and narrow-band imaging have been shown to be effective in the in vivo diagnosis of small colonic polyps. The learning curve for achieving high level of accuracy with a new technology for real-time diagnosis of small colonic polyps has not been determined.MethodsWe aimed to assess the learning curve of a novel electronic in vivo diagnosis technology (Pentax iScan) for an expert endoscopist. Patients presenting for screening colonoscopy through the UK Bowel Cancer Screening Programme were prospectively recruited. All colonoscopies were performed by a single expert endoscopist, with extensive experience in in vivo diagnosis, using Pentax EC-3890Li 1.2 Megapixel HD colonoscopes and EPKi processor. Polyps <10 mm in size were assessed sequentially using three modalities (1) White light HD endoscopy (WL), (2) Pentax iScan surface and tone enhancement, (3) IC chromoendoscopy. Optical magnification was not used. Predicted histology (non-neoplastic, adenoma, cancer) was recorded for each modality and compared to the final histopathological diagnosis. Results were analysed for sensitivity and specificity for neoplasia, and overall accuracy. To assess any learning effect results were analysed in three sets of 100 consecutive polyps.ResultsA total of 309 polyps were eligible for inclusion in the study. Mean polyp diameter was 4.1 mm, median 3 mm. 133 polyps were in the proximal colon and 176 in the distal colon. 109 polyps were non-neoplastic, 199 were adenomatous and one contained adenocarcinoma. Sensitivity and overall accuracy improved significantly for all three imaging modalities in the 3rd set of polyps as compared to sets 1 and 2 (p<0.05). In Set 3 overall accuracies of 92.7%, 93.6% and 93.6% were achieved with WL, iScan and IC respectively. There were no significant differences in overall accuracy between the three modalities in Set 3. Negative predictive values for adenomatous histology of recto-sigmoid polyps ≤5 mm for the entire study were 96.5%, 93.4% and 98.3% for WL, iScan and IC respectively.Conclusion(1) Even in expert hands there is a significant learning curve for using a new technology for the in vivo diagnosis of small colonic polyps, with improvement in performance over the first 200 polyps assessed. (2) Excellent results can be achieved once the new technology has been mastered. (3) This is the first report of results achieved with high-definition white light endoscopy which are comparable with electronic chromoendoscopy and IC chromoendoscopy.Abstract PWE-186 Table 1WLiScanICSet 1 (Polyps 1–100) Sensitivity0.7880.8680.904 Specificity0.7080.7660.729 Accuracy0.7500.8200.820Set 2 (Polyps 101–200) Sensitivity0.8660.8510.881 Specificity0.7580.7580.788 Accuracy0.8300.8200.850Set 3 (Polyps 201–309) Sensitivity0.9640.9880.976 Specificity0.8080.7690.808 Accuracy0.9270.9360.936Competing interestsNone declared.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><doi>10.1136/gutjnl-2012-302514d.186</doi></addata></record> |
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| subjects | Accuracy Adenocarcinoma Adenoma Cancer screening Colon Diagnosis Endoscopy Histology Intestine Learning Medical screening Polyps |
| title | PWE-186 iScan in the evaluation of small colonic polyps: outcomes, learning curve from a large propective series |
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