Advancements in Colonoscopy

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Optical Diagnostics".

Deadline for manuscript submissions: closed (25 February 2022) | Viewed by 9336

Special Issue Editors

Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
Interests: diagnostic and therapeutic gastrointestinal endoscopy; colonoscopy; capsule endoscopy; colorectal cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since 2019, we have all lived under a big black cloud, that of the COVID-19 pandemic. Things were quite demanding in the initial phases, with the temporary freeze of elective endoscopic activity and bowel screening programs around the world. Nevertheless, colon cancer remains a significant cause of mortality and morbidity that can only decrease by early detection and treatment. To this end, colonoscopy (conventional or not) remains the primary tool and reference standard for colonic examination. Many developments have been happening in this field, even before the pandemic: for example, new and powerful white light endoscopes with zoom and digital chromoendoscopy capabilities, the likes of which have not been seen before; the emergence of artificial intelligence; and the slow and somewhat reluctant introduction of the wireless endoscopy form of nationwide service in Scotland. In this Special Issue, we open a discussion and welcome original articles, reviews, and reports looking into new technologies, emerging service modalities, and ideas on technology adoption and the overall current and future impact of the pandemic on colonoscopy practice.

Prof. Dr. Anastasios Koulaouzidis
Dr. Ervin Toth
Guest Editors

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Keywords

  • colonoscopy
  • colonic examination
  • colon cancer
  • endoscopes
  • digital chromoendoscopy

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Published Papers (4 papers)

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Research

13 pages, 1050 KiB  
Article
The Effectiveness and Tolerability of a Very Low-Volume Bowel Preparation for Colonoscopy Compared to Low and High-Volume Polyethylene Glycol-Solutions in the Real-Life Setting
by Olga Bednarska, Nils Nyhlin, Peter Thelin Schmidt, Gabriele Wurm Johansson, Ervin Toth and Perjohan Lindfors
Diagnostics 2022, 12(5), 1155; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12051155 - 06 May 2022
Cited by 4 | Viewed by 1967
Abstract
Adequate bowel cleansing is essential for high-quality colonoscopy. Recently, a new very low-volume 1 litre (1L) polyethylene glycol (PEG) plus ascorbate solution (ASC) has been introduced. Our aims were to assess the effectiveness and tolerability of this product compared to low-volume 2L PEG-ASC [...] Read more.
Adequate bowel cleansing is essential for high-quality colonoscopy. Recently, a new very low-volume 1 litre (1L) polyethylene glycol (PEG) plus ascorbate solution (ASC) has been introduced. Our aims were to assess the effectiveness and tolerability of this product compared to low-volume 2L PEG-ASC and high-volume 4L PEG solutions, in a real-life setting. In six endoscopy units in Sweden, outpatients undergoing colonoscopy were either prescribed solutions according to local routines, or the very low-volume solution in split dose regimen. Bowel cleansing effectiveness and patient experience was assessed using the Boston Bowel preparation scale (BBPS) and a patient questionnaire. A total of 1098 patients (mean age 58 years, 52% women) were included. All subsegment and the total BBPS scores were significantly greater for 1L PEG-ASC in comparison to other solutions (p < 0.05 for 1L PEG-ASC and 4L PEG for transverse and left colon, otherwise p < 0.001). Nausea was more frequent with 1L PEG-ASC compared to 2L PEG-ASC (p < 0.001) and vomiting were more often reported compared to both other solutions (p < 0.01 and p < 0.05 for 2L PEG-ASC and 4L PEG, respectively). Smell, taste, and total experience was better for 1L PEG-ASC compared to 4L PEG (p < 0.001), and similar compared to the 2L PEG-ASC. In conclusion, 1L PEG-ASC leads to better bowel cleansing compared to 2L PEG-ASC or 4L PEG products, with similar or greater patient satisfaction. Full article
(This article belongs to the Special Issue Advancements in Colonoscopy)
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14 pages, 2891 KiB  
Article
Factors Associated with Withdrawal Time in European Colonoscopy Practice: Findings of the European Colonoscopy Quality Investigation (ECQI) Group
by Cristiano Spada, Anastasios Koulaouzidis, Cesare Hassan, Pedro Amaro, Anurag Agrawal, Lene Brink, Wolfgang Fischbach, Matthias Hünger, Rodrigo Jover, Urpo Kinnunen, Akiko Ono, Árpád Patai, Silvia Pecere, Lucio Petruzziello, Jürgen F. Riemann, Harry Staines, Ann L. Stringer, Ervin Toth, Giulio Antonelli and Lorenzo Fuccio
Diagnostics 2022, 12(2), 503; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12020503 - 15 Feb 2022
Cited by 3 | Viewed by 2433
Abstract
The European Colonoscopy Quality Investigation (ECQI) Group aims to raise awareness for improvement in colonoscopy standards across Europe. We analyzed data collected on a sample of procedures conducted across Europe to evaluate the achievement of the European Society of Gastrointestinal Endoscopy (ESGE) mean [...] Read more.
The European Colonoscopy Quality Investigation (ECQI) Group aims to raise awareness for improvement in colonoscopy standards across Europe. We analyzed data collected on a sample of procedures conducted across Europe to evaluate the achievement of the European Society of Gastrointestinal Endoscopy (ESGE) mean withdrawal time (WT) target. We also investigated factors associated with WT, in the hope of establishing areas that could lead to a quality improvement. Methods: 6445 form completions from 12 countries between 2 June 2016 and 30 April 2018 were considered for this analysis. We performed an exploratory analysis looking at WT according to the ESGE definition. Stepwise multivariable logistic regression analysis was conducted to determine the most influential associated factors after adjusting for the other pre-specified variables. Results: In 1150 qualifying colonoscopies, the mean WT was 7.8 min. Stepwise analysis, including 587 procedures where all inputs were known, found that the variables most associated with mean WT were a previous total colonoscopy in the last five years (p = 0.0011) and the time of day the colonoscopy was performed (p = 0.0192). The main factor associated with a WT < 6 min was the time of day that a colonoscopy was performed. Use of sedation was the main factor associated with a higher proportion of WT > 10 min, along with a previous colonoscopy. Conclusions: On average, the sample of European practice captured by the ECQI survey met the minimum standard set by the ESGE. However, there was variation and potential for improvement. Full article
(This article belongs to the Special Issue Advancements in Colonoscopy)
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9 pages, 1311 KiB  
Article
Odds of Incomplete Colonoscopy in Colorectal Cancer Screening Based on Socioeconomic Status
by Birgitte Skau, Ulrik Deding, Lasse Kaalby, Gunnar Baatrup, Morten Kobaek-Larsen and Issam Al-Najami
Diagnostics 2022, 12(1), 171; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12010171 - 12 Jan 2022
Cited by 5 | Viewed by 1695
Abstract
The aim of this study is to investigate the association between socioeconomic status (SES) and the risk of having an incomplete colonoscopy (IC) in the Danish Colorectal Cancer (CRC) Screening Program. In this register-based study we included 71,973 participants who underwent colonoscopy after [...] Read more.
The aim of this study is to investigate the association between socioeconomic status (SES) and the risk of having an incomplete colonoscopy (IC) in the Danish Colorectal Cancer (CRC) Screening Program. In this register-based study we included 71,973 participants who underwent colonoscopy after a positive fecal immunochemical test in the Danish CRC Screening Program. The main exposure, SES, was defined by income and education, and the outcome by complete or incomplete colonoscopy. Among the participants, 5428 (7.5%) had an incomplete colonoscopy. The odds ratio (OR) for ICs due to inadequate bowel preparation was 1.67 (95% CI: 1.46; 1.91) for income in the 1 quartile compared to income in the 4th quartile. ORs for income in the 2nd quartile was 1.38 (95% CI: 1.21; 1.56) and 1.17 (95% CI: 1.03; 1.33) for income in the 3rd quartile. For the educational level, an association was seen for high school/vocational education with an OR of 0.87 (95% CI: 0.79; 0.97) compared to higher education. For ICs due to other reasons, the level of income was associated with the risk of having an IC with an OR of 1.19 (95% CI: 1.05; 1.35) in the 1st quartile and an OR of 1.19 (95% CI: 1.06; 1.34) in the 2nd quartile. For the educational level, there were no significant associations. Low income is associated with high risk of having an IC, whereas educational level does not show the same unambiguous association. Full article
(This article belongs to the Special Issue Advancements in Colonoscopy)
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11 pages, 1723 KiB  
Article
Detection Accuracy and Latency of Colorectal Lesions with Computer-Aided Detection System Based on Low-Bias Evaluation
by Hiroaki Matsui, Shunsuke Kamba, Hideka Horiuchi, Sho Takahashi, Masako Nishikawa, Akihiro Fukuda, Aya Tonouchi, Natsumaro Kutsuna, Yuki Shimahara, Naoto Tamai and Kazuki Sumiyama
Diagnostics 2021, 11(10), 1922; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11101922 - 17 Oct 2021
Cited by 1 | Viewed by 1892
Abstract
We developed a computer-aided detection (CADe) system to detect and localize colorectal lesions by modifying You-Only-Look-Once version 3 (YOLO v3) and evaluated its performance in two different settings. The test dataset was obtained from 20 randomly selected patients who underwent endoscopic resection for [...] Read more.
We developed a computer-aided detection (CADe) system to detect and localize colorectal lesions by modifying You-Only-Look-Once version 3 (YOLO v3) and evaluated its performance in two different settings. The test dataset was obtained from 20 randomly selected patients who underwent endoscopic resection for 69 colorectal lesions at the Jikei University Hospital between June 2017 and February 2018. First, we evaluated the diagnostic performances using still images randomly and automatically extracted from video recordings of the entire endoscopic procedure at intervals of 5 s, without eliminating poor quality images. Second, the latency of lesion detection by the CADe system from the initial appearance of lesions was investigated by reviewing the videos. A total of 6531 images, including 662 images with a lesion, were studied in the image-based analysis. The AUC, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 0.983, 94.6%, 95.2%, 68.8%, 99.4%, and 95.1%, respectively. The median time for detecting colorectal lesions measured in the lesion-based analysis was 0.67 s. In conclusion, we proved that the originally developed CADe system based on YOLO v3 could accurately and instantaneously detect colorectal lesions using the test dataset obtained from videos, mitigating operator selection biases. Full article
(This article belongs to the Special Issue Advancements in Colonoscopy)
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