Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video)

Ian M. Gralnek; David L. Carr-Locke; Ori Segol; Zamir Halpern; Peter D. Siersema; Alan Sloyer; Jay Fenster; Blair S. Lewis; Erwin Santo; Alain Suissa; Meytal Segev

doi:10.1016/j.gie.2012.12.011

Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video)

Ian M. Gralnek
, David L. Carr-Locke
, Ori Segol
, Zamir Halpern
, Peter D. Siersema
, Alan Sloyer
, Jay Fenster
, Blair S. Lewis
, Erwin Santo
, Alain Suissa
, Meytal Segev

Research output: Contribution to journal › Article › peer-review

49 Scopus citations

Abstract

Background: Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. Objective: To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. Design: Prospective, multicenter. Setting: Six endoscopy units (3 in the United States and 3 in Israel). Patients: In vitro colon model with simulated colon polyps (n = 21 metallic beads). Interventions: Detection of simulated colon polyps on colonoscope withdrawal. Main Outcome Measurements: Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy. Results: On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0%) right colon, 2.4 ± 0.87 (48.0%) transverse colon, and 5.7 ± 1.5 (51.8%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7% polyp detection rate (P <.001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0%) right colon, 4.0 ± 0.87 (80.0%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3%) left colon (all comparisons, P <.001). Importantly, the ultrawide-viewing mode detected significantly more "hidden" simulated polyps (81.9% vs 31.9%, P <.0001). Limitations: Nonrandomized design, use of a colon model, and "simulated" colon polyps. Conclusions: Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.

Original language	English
Pages (from-to)	472-479
Number of pages	8
Journal	Gastrointestinal Endoscopy
Volume	77
Issue number	3
DOIs	https://doi.org/10.1016/j.gie.2012.12.011
State	Published - Mar 2013

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Gralnek, I. M., Carr-Locke, D. L., Segol, O., Halpern, Z., Siersema, P. D., Sloyer, A., Fenster, J., Lewis, B. S., Santo, E., Suissa, A., & Segev, M. (2013). Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video). Gastrointestinal Endoscopy, 77(3), 472-479. https://doi.org/10.1016/j.gie.2012.12.011

@article{99b9a2be369242a88245d912ed435993,

title = "Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video)",

abstract = "Background: Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. Objective: To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. Design: Prospective, multicenter. Setting: Six endoscopy units (3 in the United States and 3 in Israel). Patients: In vitro colon model with simulated colon polyps (n = 21 metallic beads). Interventions: Detection of simulated colon polyps on colonoscope withdrawal. Main Outcome Measurements: Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy. Results: On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9\% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0\%) right colon, 2.4 ± 0.87 (48.0\%) transverse colon, and 5.7 ± 1.5 (51.8\%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7\% polyp detection rate (P <.001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0\%) right colon, 4.0 ± 0.87 (80.0\%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3\%) left colon (all comparisons, P <.001). Importantly, the ultrawide-viewing mode detected significantly more {"}hidden{"} simulated polyps (81.9\% vs 31.9\%, P <.0001). Limitations: Nonrandomized design, use of a colon model, and {"}simulated{"} colon polyps. Conclusions: Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.",

author = "Gralnek, \{Ian M.\} and Carr-Locke, \{David L.\} and Ori Segol and Zamir Halpern and Siersema, \{Peter D.\} and Alan Sloyer and Jay Fenster and Lewis, \{Blair S.\} and Erwin Santo and Alain Suissa and Meytal Segev",

note = "Funding Information: DISCLOSURE: Drs Gralnek, Halpern, Siersema, Carr-Locke, Segol, and Suissa are consultants for Peer Medical Ltd. Dr Segev is the Medical Director of Peer Medical Ltd. This study was sponsored by Peer Medical Ltd, Caesaria, Israel. ",

year = "2013",

month = mar,

doi = "10.1016/j.gie.2012.12.011",

language = "English",

volume = "77",

pages = "472--479",

journal = "Gastrointestinal Endoscopy",

issn = "0016-5107",

publisher = "Elsevier Inc.",

number = "3",

}

Gralnek, IM, Carr-Locke, DL, Segol, O, Halpern, Z, Siersema, PD, Sloyer, A, Fenster, J, Lewis, BS, Santo, E, Suissa, A & Segev, M 2013, 'Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video)', Gastrointestinal Endoscopy, vol. 77, no. 3, pp. 472-479. https://doi.org/10.1016/j.gie.2012.12.011

Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video). / Gralnek, Ian M.; Carr-Locke, David L.; Segol, Ori et al.
In: Gastrointestinal Endoscopy, Vol. 77, No. 3, 03.2013, p. 472-479.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform

T2 - A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video)

AU - Gralnek, Ian M.

AU - Carr-Locke, David L.

AU - Segol, Ori

AU - Halpern, Zamir

AU - Siersema, Peter D.

AU - Sloyer, Alan

AU - Fenster, Jay

AU - Lewis, Blair S.

AU - Santo, Erwin

AU - Suissa, Alain

AU - Segev, Meytal

N1 - Funding Information: DISCLOSURE: Drs Gralnek, Halpern, Siersema, Carr-Locke, Segol, and Suissa are consultants for Peer Medical Ltd. Dr Segev is the Medical Director of Peer Medical Ltd. This study was sponsored by Peer Medical Ltd, Caesaria, Israel.

PY - 2013/3

Y1 - 2013/3

N2 - Background: Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. Objective: To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. Design: Prospective, multicenter. Setting: Six endoscopy units (3 in the United States and 3 in Israel). Patients: In vitro colon model with simulated colon polyps (n = 21 metallic beads). Interventions: Detection of simulated colon polyps on colonoscope withdrawal. Main Outcome Measurements: Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy. Results: On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0%) right colon, 2.4 ± 0.87 (48.0%) transverse colon, and 5.7 ± 1.5 (51.8%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7% polyp detection rate (P <.001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0%) right colon, 4.0 ± 0.87 (80.0%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3%) left colon (all comparisons, P <.001). Importantly, the ultrawide-viewing mode detected significantly more "hidden" simulated polyps (81.9% vs 31.9%, P <.0001). Limitations: Nonrandomized design, use of a colon model, and "simulated" colon polyps. Conclusions: Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.

AB - Background: Although colonoscopy is the criterion standard for detecting colorectal adenomas and cancers, a significant percentage of adenomas are missed. Objective: To compare forward-viewing with ultrawide-viewing colonoscopy in the detection of simulated colon polyps in an in vitro colon model. Design: Prospective, multicenter. Setting: Six endoscopy units (3 in the United States and 3 in Israel). Patients: In vitro colon model with simulated colon polyps (n = 21 metallic beads). Interventions: Detection of simulated colon polyps on colonoscope withdrawal. Main Outcome Measurements: Incremental detection of simulated colon polyps and endoscopist evaluation of the usability, visibility, and maneuverability of ultrawide-viewing colonoscopy. Results: On forward-viewing colonoscopy, the number of simulated polyps (mean ± standard deviation) detected per endoscopist was 11.1 ± 2.3 polyps, a 52.9% detection rate. Simulated polyp detection rates per colon segment were 3.0 ± 0.93 (60.0%) right colon, 2.4 ± 0.87 (48.0%) transverse colon, and 5.7 ± 1.5 (51.8%) left colon. On ultrawide-viewing colonoscopy, the simulated polyp detection rate per endoscopist significantly increased to 18.0 ± 1.98 polyps, an overall 85.7% polyp detection rate (P <.001). Simulated polyp detection rates were also significantly higher by using the ultrawide-viewing mode in each colon segment, 4.5 ± 0.65 polyps (90.0%) right colon, 4.0 ± 0.87 (80.0%) polyps transverse colon, and 9.6 ± 1.28 polyps (87.3%) left colon (all comparisons, P <.001). Importantly, the ultrawide-viewing mode detected significantly more "hidden" simulated polyps (81.9% vs 31.9%, P <.0001). Limitations: Nonrandomized design, use of a colon model, and "simulated" colon polyps. Conclusions: Ultrawide-view colonoscopy significantly improved simulated polyp detection in a colon model. Clinical studies in human subjects should be pursued to further evaluate this new endoscopic technology.

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AN - SCOPUS:84873633269

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JF - Gastrointestinal Endoscopy

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Gralnek IM, Carr-Locke DL, Segol O, Halpern Z, Siersema PD, Sloyer A et al. Comparison of standard forward-viewing mode versus ultrawide-viewing mode of a novel colonoscopy platform: A prospective, multicenter study in the detection of simulated polyps in an in vitro colon model (with video). Gastrointestinal Endoscopy. 2013 Mar;77(3):472-479. doi: 10.1016/j.gie.2012.12.011