The Usefulness of I-scan in Screening Colonoscopy
Condition: Colorectal Neoplasm
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      Image-enhanced endoscopy in screening colonoscopy

        1. useful tool for detecting subtle epithelial lesions

        2. useful tool for predicting real-time histology of epithelial lesions. Among
           image-enhancing techniques, i-SCAN is new developed and the practical usefulness of
           i-scan for screening colonoscopy has not been investigated yet.
    

Detailed description: 
      New technologies have been developed to enhance the visualization of colorectal mucosa to
      unmask even minute mucosal lesions and identify neoplastic lesion from non-neoplastic
      lesions. In particular, there appears to be strong evidence that pan-colonic chromoendoscopy
      enhances the detection of colorectal neoplasm in the colon and rectum. However, this
      technique is time-consuming because of both the dye spraying and suction of collected dye in
      the dependent portion, and therefore it is unsuitable for routine application. To overcome
      this inconvenience, optical-digital method involves conversion of the optical characteristics
      of the light used for illumination or imaging with a light source differing in optical
      characteristics from ordinary white light (WL), such as narrow band imaging (NBI), Fujinon
      imaging color enhancement (FICE), auto-fluorescence imaging (AFI) and infra-red imaging
      (IRI).

      I-scan technology is the newly developed image enhanced endoscopy technology, classified as a
      digital contrast method among endoscopic imaging techniques.19 I-scan has three modes of
      image enhancement, i.e. surface enhancement (SE); contrast enhancement (CE); and tone
      enhancement (TE). The three modes (SE, CE and TE) are arranged in series, therefore, it is
      possible to apply two or more of these three modes at one time. Switching the levels or modes
      of enhancements can be done on a real-time basis, without any time lag by pushing a relevant
      button, thus enabling efficient endoscopic observation. Furthermore, while NBI) images are
      much darker than conventional white light (WL) images, i-scan images are as bright as
      conventional WL images, therefore, i-scan is able to observe much larger areas in a distant
      view compared with NBI. Consequently, i-scan might be more useful for performing screening
      endoscopy).

      However, the actual usefulness of I-scan in enhancing the detection of colonic neoplastic
      lesions is not known yet in screening colonoscopy. Therefore, we tried to evaluate the
      hypothesis that, in subjects undergoing colonoscopy screening, the routine application of
      i-scan during withdrawal could improve adenoma detection as compared with standard WL
      examination.
    

Intervention name(s): i-scan CE, SE, TE mode
Intervention type(s): Procedure
Intervention description(s): I-scan technology is the newly developed image enhanced endoscopy technology, classified as a digital contrast method among endoscopic imaging techniques. I-scan has three modes of image enhancement, i.e. surface enhancement (SE); contrast enhancement (CE); and tone enhancement (TE). The three modes (SE, CE and TE) are arranged in series, therefore, it is possible to apply two or more of these three modes at one time. Switching the levels or modes of enhancements can be done on a real-time basis, without any time lag by pushing a relevant button, thus enabling efficient endoscopic observation.
Other intervention name(s): EPKi
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Diagnostic
Keywords: screening colonoscopy