14% Increased ADR
How Can Olympus Technology Help?
How can Olympus technology help you to increase your ADR?
Early studies with EVIS EXERA III and EVIS LUCERA ELITE indicate that NBI improves lesion detection in the colon. (20,21) A single-center RCT with EVIS EXERA III showed that ADR increased by approximately 14% to 48.3% when using NBI compared to white light. (20) In a multi-center RCT NBI with EVIS LUCERA ELITE decreased polyp miss rates by 29%. (21) Efficient reporting of polyp histology is critical to monitor ADR. Here, three large meta-analyses prove that optical diagnosis with NBI is feasible and fulfills the ASGE PIVI criteria for implementing a RESECT & LEAVE and RESECT & DISCARD strategy for diminutive colorectal polyps (<5 mm). (22,23,24)
Dual Focus may also be of importance for the diagnostic process: Dual Focus NBI was not only very accurate in optical diagnosis but also increased the ratio of high-confidence decisions by 14%. (25)
The European Society of Gastrointestinal Endoscopy (ESGE) implemented optical diagnosis of diminutive colorectal polyps into their guideline (26), which may not only be important for the diagnostic process but also allow an easier way to monitor ADR and thus raise the quality of screening colonoscopies.
Why is ADR difficult to determine?
ADR is a cumulative indicator which is influenced by a number of demographic, procedural, and equipment-related factors. ADR is influenced by gender
(15) and differs between facilities depending on their patient demography. Various procedural factors such as withdrawal time
(47), preparation quality
(17), scheduling
(18), and use of water-exchange colonoscopy
(19), as well as the use of HDTV equipment
(20) were identified to significantly increase ADR.
To properly report and monitor ADR, feedback from histology is required. Accordingly, additional time and effort is needed to adjust patient records once the histology results are known.
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Clincial Studies
- 1.Update on Endoscopic Tissue Sampling Devices.
- 2.The Role of Endoscopy in Barrett‘s Esophagus and Other Premalignant Conditions of the Esophagus.
- 3.American Gastroenterological Association Institute Guideline on the Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions
- 4.The Role of Endoscopy in Inflammatory Bowel Disease
- 5.The Seattle Protocol Does Not More Reliably Predict the Detection of Cancer at the Time of Esophagectomy Than a Less Intensive Surveillance Protocol
- 6.Random Biopsies Taken During Colonoscopic Surveillance of Patients with Longstanding Ulcerative Colitis: Low Yield and Absence of Clinical Consequences
- 7.Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging
- 8.Endoscopic Prediction of Deep Submucosal Invasive Carcinoma: Validation of the Narrow-Band Imaging International Colorectal Endoscopic (NICE) Classification
- 9.Narrow-Band Imaging with Dual Focus Magnification in Differentiating Colorectal Neoplasia
- 10.Standard Endoscopy with Random Biopsies Versus Narrow Band Imaging Targeted Biopsies in Barrett‘s Oesophagus: A Prospective, International, Randomised Controlled Trial
- 11.Advanced Imaging Technologies Increase Detection of Dysplasia and Neoplasia in Patients with Barrett‘s Esophagus: A Meta-Analysis and Systematic Review
- 12.White-Light or Narrow-Band Imaging Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study
- 13.Narrow Band Imaging with Magnification Endoscopy for Celiac Disease: Results from a Prospective, Single-Center Study
- 14.Adenoma Detection Rate and Risk of Colorectal Cancer and Death
- 15.Improving Measurement of the Adenoma Detection Rate and Adenoma Per Colonoscopy Quality Metric: The Indiana University Experience
- 16.Impact of Bowel Preparation with Low-Volume (2-Liter) and Intermediate-Volume (3-Liter) Polyethylene Glycol on Colonoscopy Quality: A Prospective Observational Study
- 17.Adenoma Detection Rate Is not Influenced by the Timing of Colonoscopy When Performed in Half-Day Blocks
- 18.A Patient-Blinded Randomized, Controlled Trial Comparing Air Insufflation, Water Immersion, and Water Exchange During Minimally Sedated Colonoscopy
- 19.High Definition Colonoscopy vs. Standard Video Endoscopy for the Detection of Colonic Polyps: A Meta-Analysis
- 20.Detection of Colorectal Adenoma by Narrow Band Imaging (HQ190) vs. High-Definition White Light Colonoscopy: A Randomized Controlled Trial
- 21.Next-Generation Narrow Band Imaging System for Colonic Polyp Detection: A Prospective Multicenter Randomized Trial
- 22.Narrow Band Imaging to Differentiate Neoplastic and Non-Neoplastic Colorectal Polyps in Real Time: A Meta-Analysis of Diagnostic Operating Characteristics
- 23.Diagnostic Performance of Narrowed Spectrum Endoscopy, Autofluorescence Imaging, and Confocal Laser Endomicroscopy for Optical Diagnosis of Colonic Polyps: A Meta-Analysis
- 24.ASGE Technology Committee Systematic Review and Meta-Analysis Assessing the ASGE PIVI Thresholds for Adopting Real-Time Endoscopic Assessment of the Histology of Diminutive Colorectal Polyps
- 25.Real-Time Optical Diagnosis for Diminutive Colorectal Polyps Using Narrow-Band Imaging: The VALID Randomised Clinical Trial
- 26.Advanced Imaging for Detection and Differentiation of Colorectal Neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
- 27.An Analysis of the Learning Curve to Achieve Competency at Colonoscopy Using the JETS Database
- 28.Patient Pain During Colonoscopy: An Analysis Using Real-Time Magnetic Endoscope Imaging
- 29.Magnetic Endoscopic Imaging Versus Standard Colonoscopy in a Routine Colonoscopy Setting: A Randomized, Controlled Trial.
- 30.Magnetic Endoscopic Imaging Versus Standard Colonoscopy: Meta-Analysis of Randomized Controlled Trials
- 31.Magnetic Endoscopic Imaging as an Adjuvant to Elective Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- 32.Does “Responsive Insertion Technology” Improve Practice of Colonoscopy? Results of a Randomized Study
- 33.Conscious Sedation and Analgesia in Colonoscopy [...]
- 34.Safety Analysis of Endoscopist-Directed [...]
- 35.Position Change During Colonoscope Withdrawal Increases Polyp and Adenoma Detection in the Right but not in the Left Side of the Colon: Results of a Randomized Controlled Trial
- 36.Variable Stiffness Colonoscope Versus Regular Adult Colonoscope: Meta-Analysis of Randomized Controlled Trials
- 37.[...] Sedation for Colonoscopy with a New Ultrathin or a Standard Endoscope: A Prospective Randomized Controlled Study
- 38.Long-Term Colorectal-Cancer Incidence and Mortality after Lower Endoscopy
- 39.The Comparative Cost-Effectiveness of Colorectal Cancer Screening Using Faecal Immunochemical Test Versus Colonoscopy
- 40.Trends in Adenoma Detection Rates During the First 10 Years of the German Screening Colonoscopy Program
- 41.Global Epidemiology of Barrett‘s Esophagus
- 42.Cost Considerations in Implementing a Screening and Surveillance Strategy for Barrett‘s Oesophagus
- 43.Preliminary Feasibility Study Using a Novel Narrow-Band Imaging System with Dual Focus Magnification Capability in Barrett‘s Esophagus: Is the Time Ripe to Abandon Random Biopsies?
- 44.Carbon Dioxide Insufflation Versus Conventional Air Insufflation for Colonoscopy: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials
- 45.Reduced Pain During Screening Colonoscopy with an Ultrathin Colonoscope: A Randomized Controlled Trial
- 46.ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus.
- 47.Longer Withdrawal Time Is Associated With a Reduced Incidence of Interval Cancer After Screening Colonoscopy.
- 48.Virtual chromoendoscopy to assess colorectal polyps during colonoscopy