14% Increased ADR
How Can Olympus Technology Help?
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) Thus, both systems effectively contribute to improve detection. 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.
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
(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.