CONCLUSIONS: HD+ colonoscopy with I-Scan is superior to standard video colonoscopy in

detecting patients with colorectal neoplasia (abnormal proliferation of benign or malignant cells)
based on this prospective, randomized, controlled trial.

1. Endoscopy. 2010 Oct;42(10):827-33. Epub 2010 Aug 27.

High definition colonoscopy combined with i-Scan is
superior in the detection of colorectal neoplasias
compared with standard video colonoscopy: a prospective
randomized controlled trial.
Hoffman A, Sar F, Goetz M, Tresch A, Mudter J, Biesterfeld S, Galle PR, Neurath MF,
Kiesslich R.
I Med Clinic, Johannes Gutenberg University of Mainz, Langenbeckstrasse 1, Mainz,
Germany. AHoff66286@aol.com
Comment in:
 Endoscopy. 2010 Oct;42(10):866-9.
Abstract
INTRODUCTION: Colonoscopy is the accepted gold standard for the detection of colorectal
cancer. The aim of the current study was to prospectively compare high definition plus
(HD+) colonoscopy with I-Scan functionality (electronic staining) vs. standard video
colonoscopy. The primary endpoint was the detection of patients having colon cancer or
at least one adenoma. (An adenoma is a benign tumor that develops from epithelial tissue. Adenomas
in the colon are often referred to as adenomatous polyps. Although adenomas aren't cancerous, they have
the potential to become cancerous) Most colorectal cancer develops from adenomatous polyps. Adenomas
that turn into cancer are referred to as adenocarcinomas.)
METHODS: A total of 220 patients due to undergo screening colonoscopy,
postpolypectomy surveillance or with a positive occult blood test were randomized in a
1 : 1 ratio to undergo HD+ colonoscopy in conjunction with I-Scan surface enhancement
(90i series, Pentax, Tokyo, Japan) or standard video colonoscopy (EC-3870FZK, Pentax).
Detected colorectal lesions were judged according to type, location, and size. Lesions
were characterized in the HD+ group by using further I-Scan functionality (p- and v-
modes) to analyze pattern and vessel architecture. Histology was predicted and biopsies
or resections were performed on all identified lesions.
RESULTS: HD+ colonoscopy with I-Scan functionality detected significantly more patients
with colorectal neoplasia (38 %) compared with standard resolution endoscopy (13 %) (200
patients finally analyzed; 100 per arm). Significantly more neoplastic (abnormal new growth
of tissue) (adenomatous and cancerous) lesions and more flat adenomas could be detected
using high definition endoscopy with surface enhancement. Final histology could be
predicted with high accuracy (98.6 %) within the HD+ group.
CONCLUSIONS: HD+ colonoscopy with I-Scan is superior to standard video colonoscopy in
detecting patients with colorectal neoplasia based on this prospective, randomized,
controlled trial.
© Georg Thieme Verlag KG Stuttgart · New York.

1|P a g e