BLI, NBI or White Light Colonoscopy for Proximal Colonic Adenoma

Study Overview
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Brief Summary
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This is a prospective randomised trial comparing the proximal adenoma detection rate and miss rate by blue laser imaging (BLI), narrow band imaging or white light colonoscopy.

Detailed Description
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Study population: Consecutive adult patients, age 40 or above, undergoing outpatient colonoscopy in the Queen Mary Hospital are invited to participate in this prospective randomized study. Patients are excluded if they are unable to provide informed consent or have undergone previous colorectal resection, or have personal history of colorectal cancer, inflammatory bowel disease, familial adenomatous polyposis, Peutz-Jeghers syndrome, or other polyposis syndromes. Patients who are considered to be unsafe for polypectomy including patients with bleeding tendency and those with severe comorbid illnesses will be excluded. In addition, patients are excluded post-randomization if either the cecum could not be intubated for various reasons or Boston Bowel Preparation Scale (BBPS) score is <2. Study design and randomization: This is a prospective randomized crossover trial comparing the proximal adenoma detection rate and miss rate of BLI (ELUXEO endoscopic system) vs NBI (290 video system) vs WLI which is conducted in the Endoscopy Center of the Queen Mary Hospital of Hong Kong. Eligible patients are randomly allocated to four groups in a 1:1:1 ratio to undergo tandem colonoscopy of the proximal colon, defined as cecum to splenic flexure. The three groups are: (1) NBI follow by WLI; (2) BLI follow up WLI; (3) WLI follow by WLI. Randomization will be carried out by computer generated random sequences and stratified according to endoscopist's experiences (experienced versus fellows) and indications of colonoscopy (symptomatic vs screening/surveillance). All procedures are performed with high-definition endoscopes. The patients are blinded to the group assignment.

Official Title
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Blue Laser Imaging Versus Narrow Band Imaging Versus White Light Imaging for Detection of Adenoma in the Proximal Colon: A Prospective Randomized Study

Conditions
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Colon Adenoma

Intervention / Treatment
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* Procedure: Tandem colonoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 40 or above scheduled for colonoscopy Exclusion Criteria: unable to provide informed consent have undergone previous colorectal resection, personal history of colorectal cancer, inflammatory bowel disease, familial adenomatous polyposis, Peutz-Jeghers syndrome, or other polyposis syndromes. Patients who are considered to be unsafe for polypectomy including patients with bleeding tendency and those with severe comorbid illnesses poor bowel preparation

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective randomized design
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: NBI<br>Tandem colonoscopy with NBI follow by WL | Procedure: Tandem colonoscopy<br>* Tandem colonoscopy with different image modalities<br>|
| Active Comparator: BLI<br>Tandem colonoscopy with BLI follow by WLI | Procedure: Tandem colonoscopy<br>* Tandem colonoscopy with different image modalities<br>|
| Experimental: WLI<br>Tandem colonoscopy with WLI follow by WL | Procedure: Tandem colonoscopy<br>* Tandem colonoscopy with different image modalities<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proximal adenoma detection rate | proportion of patients with proximal adenoma detected on first examination | one day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| proximal polyp detection rate | proportion of patients with proximal polyp detected on first examination | one day | 
| proximal adenoma miss rate | proportion of patients with proximal adenoma detected on second examination | one day | 
| proximal polyp miss rate | proportion of patients with proximal polyp detected on second examination | one day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colonoscopy