Abstract
Background and Aims: Colorectal flat (nonpolypoid) lesions can be overlooked during colonoscopy. This study evaluated the efficacy of updated autofluorescence imaging (AFI) for detecting colorectal flat neoplasms. Methods: This was a prospective, multicenter, randomized controlled trial in 9 Japanese tertiary institutions. Patients undergoing colonoscopy because of positive fecal immunochemical tests, surveillance after polypectomy, or investigation of minor symptoms were enrolled and randomly assigned to either the white-light imaging (WLI) or the AFI group. Primary outcome measurement was number of flat neoplasms per patient. Results: From November 2015 to June 2017, 817 patients were enrolled. After excluding 15 patients, 802 were finally analyzed (404, WLI; 398, AFI). Patients’ backgrounds (sex, age, indication of colonoscopy, experience of endoscopists) and quality of colonoscopy (bowel preparation, sedative use, cecal insertion rate, insertion and withdrawal time) were not different between groups. Number of flat neoplasms in each patient was significantly higher in the AFI than in the WLI group (.87 [95% confidence interval [CI],.78-.97] vs.53 [95% CI,.46-.61]), whereas overall and polypoid neoplasm detection was not significantly different between the groups (1.33 [95% CI, 1.22-1.45] vs 1.14 [95% CI, 1.03-1.24],.46 [95% CI,.40-.53] vs.60 [95% CI,.53-.68]). Flat neoplasms were more frequently detected in the right-sided colon with AFI (.61 [95% CI,.54-.70] vs.30 [95% CI,.25-.36]) but not in the left-sided colon and rectum (.26 [95% CI,.21-.32] vs.23 [95% CI,.19-.28]). Conclusions: Updated AFI improves the detection of flat colorectal neoplasms in the right-sided colon compared with WLI. (Clinical trial registration number: UMIN000019355.)
| Original language | English |
|---|---|
| Pages (from-to) | 460-469 |
| Number of pages | 10 |
| Journal | Gastrointestinal endoscopy |
| Volume | 89 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2019 |
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All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Gastroenterology
Cite this
Efficacy of autofluorescence imaging for flat neoplasm detection : a multicenter randomized controlled trial (A-FLAT trial). / Takeuchi, Yoji; Sawaya, Manabu; Oka, Shiro; Tamai, Naoto; Kawamura, Takuji; Uraoka, Toshio; Ikematsu, Hiroaki; Tomohiko, Moriyama; Arao, Masamichi; Ishikawa, Hideki; Ito, Yuri; Matsuda, Takahisa.
In: Gastrointestinal endoscopy, Vol. 89, No. 3, 01.03.2019, p. 460-469.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Efficacy of autofluorescence imaging for flat neoplasm detection
T2 - a multicenter randomized controlled trial (A-FLAT trial)
AU - Takeuchi, Yoji
AU - Sawaya, Manabu
AU - Oka, Shiro
AU - Tamai, Naoto
AU - Kawamura, Takuji
AU - Uraoka, Toshio
AU - Ikematsu, Hiroaki
AU - Tomohiko, Moriyama
AU - Arao, Masamichi
AU - Ishikawa, Hideki
AU - Ito, Yuri
AU - Matsuda, Takahisa
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background and Aims: Colorectal flat (nonpolypoid) lesions can be overlooked during colonoscopy. This study evaluated the efficacy of updated autofluorescence imaging (AFI) for detecting colorectal flat neoplasms. Methods: This was a prospective, multicenter, randomized controlled trial in 9 Japanese tertiary institutions. Patients undergoing colonoscopy because of positive fecal immunochemical tests, surveillance after polypectomy, or investigation of minor symptoms were enrolled and randomly assigned to either the white-light imaging (WLI) or the AFI group. Primary outcome measurement was number of flat neoplasms per patient. Results: From November 2015 to June 2017, 817 patients were enrolled. After excluding 15 patients, 802 were finally analyzed (404, WLI; 398, AFI). Patients’ backgrounds (sex, age, indication of colonoscopy, experience of endoscopists) and quality of colonoscopy (bowel preparation, sedative use, cecal insertion rate, insertion and withdrawal time) were not different between groups. Number of flat neoplasms in each patient was significantly higher in the AFI than in the WLI group (.87 [95% confidence interval [CI],.78-.97] vs.53 [95% CI,.46-.61]), whereas overall and polypoid neoplasm detection was not significantly different between the groups (1.33 [95% CI, 1.22-1.45] vs 1.14 [95% CI, 1.03-1.24],.46 [95% CI,.40-.53] vs.60 [95% CI,.53-.68]). Flat neoplasms were more frequently detected in the right-sided colon with AFI (.61 [95% CI,.54-.70] vs.30 [95% CI,.25-.36]) but not in the left-sided colon and rectum (.26 [95% CI,.21-.32] vs.23 [95% CI,.19-.28]). Conclusions: Updated AFI improves the detection of flat colorectal neoplasms in the right-sided colon compared with WLI. (Clinical trial registration number: UMIN000019355.)
AB - Background and Aims: Colorectal flat (nonpolypoid) lesions can be overlooked during colonoscopy. This study evaluated the efficacy of updated autofluorescence imaging (AFI) for detecting colorectal flat neoplasms. Methods: This was a prospective, multicenter, randomized controlled trial in 9 Japanese tertiary institutions. Patients undergoing colonoscopy because of positive fecal immunochemical tests, surveillance after polypectomy, or investigation of minor symptoms were enrolled and randomly assigned to either the white-light imaging (WLI) or the AFI group. Primary outcome measurement was number of flat neoplasms per patient. Results: From November 2015 to June 2017, 817 patients were enrolled. After excluding 15 patients, 802 were finally analyzed (404, WLI; 398, AFI). Patients’ backgrounds (sex, age, indication of colonoscopy, experience of endoscopists) and quality of colonoscopy (bowel preparation, sedative use, cecal insertion rate, insertion and withdrawal time) were not different between groups. Number of flat neoplasms in each patient was significantly higher in the AFI than in the WLI group (.87 [95% confidence interval [CI],.78-.97] vs.53 [95% CI,.46-.61]), whereas overall and polypoid neoplasm detection was not significantly different between the groups (1.33 [95% CI, 1.22-1.45] vs 1.14 [95% CI, 1.03-1.24],.46 [95% CI,.40-.53] vs.60 [95% CI,.53-.68]). Flat neoplasms were more frequently detected in the right-sided colon with AFI (.61 [95% CI,.54-.70] vs.30 [95% CI,.25-.36]) but not in the left-sided colon and rectum (.26 [95% CI,.21-.32] vs.23 [95% CI,.19-.28]). Conclusions: Updated AFI improves the detection of flat colorectal neoplasms in the right-sided colon compared with WLI. (Clinical trial registration number: UMIN000019355.)
UR - http://www.scopus.com/inward/record.url?scp=85059804099&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059804099&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2018.11.012
DO - 10.1016/j.gie.2018.11.012
M3 - Article
C2 - 30452914
AN - SCOPUS:85059804099
VL - 89
SP - 460
EP - 469
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 3
ER -