2018 Volume 4 Issue 1 Pages 6-10
Objectives: Full-spectrum endoscopy (FUSE) provides a 330° angle of view with two side-viewing cameras in addition to a forward-viewing camera and may improve the colorectal polyp detection rate in blind spots. We evaluated whether FUSE improved colonic polyp detection in a single-center, randomized, crossover trial.
Methods: Between July 2016 and May 2017, 55 participants (40 men, 15 women) aged 23 to 82 years were enrolled for colorectal polyp screening. Participants were randomly allocated to a forward-viewing (FV)-first group or a FUSE-first group, with stratification according to participant age, sex, and endoscopist. The right colon was examined twice in succession from the cecum to the splenic flexure. Colonic polyp miss rates (PMRs) and endoscopic observation times were compared.
Results: Five participants were excluded: three because of insertion difficulty and two because of reinsertion difficulty. In the per-protocol analysis, 23 participants (46.0%) were randomly assigned to the FUSE-first group and 27 (54.0%) to the FV-first group. In the per-lesion analysis, the PMR was significantly lower with FUSE (1/29, 3.4%) than with FV (12/39, 30.7%; P=0.025). However, by per-participant analysis, polyp detection rates were not significantly different (11/23 [47.8%] with FUSE vs 9/27 [33.3%] with FV; P=0.667). All missed polyps were less than 6 mm in size. The observation time was significantly longer with FUSE than with FV in the FUSE-first group, but not in the FV-first group.
Conclusions: This study provides evidence that FUSE improves colonic polyp detection, especially in the right colon, and might improve interval colorectal cancer screening efficacy.
