Clinical Endoscopy

Reviews

Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials: Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita; Clin Endosc 2023;56(5):553-562. Published online July 26, 2023; DOI: https://doi.org/10.5946/ce.2023.055

Colonoscopy plays an important role in reducing the incidence and mortality of colorectal cancer by detecting adenomas and other precancerous lesions. Image-enhanced endoscopy (IEE) increases lesion visibility by enhancing the microstructure, blood vessels, and mucosal surface color, resulting in the detection of colorectal lesions. In recent years, various IEE techniques have been used in clinical practice, each with its unique characteristics. Numerous studies have reported the effectiveness of IEE in the detection of colorectal lesions. IEEs can be divided into two broad categories according to the nature of the image: images constructed using narrowband wavelength light, such as narrowband imaging and blue laser imaging/blue light imaging, or color images based on white light, such as linked color imaging, texture and color enhancement imaging, and i-scan. Conversely, artificial intelligence (AI) systems, such as computer-aided diagnosis systems, have recently been developed to assist endoscopists in detecting colorectal lesions during colonoscopy. To better understand the features of each IEE, this review presents the effectiveness of each type of IEE and their combination with AI for colorectal lesion detection by referencing the latest research data.

Citations

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Fumiaki Ishibashi, Sho Suzuki
Digestive Endoscopy.2025; 37(2): 147. CrossRef
Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
European cancer mortality predictions for the year 2025 with focus on breast cancer
C. Santucci, S. Mignozzi, F. Levi, M. Malvezzi, P. Boffetta, E. Negri, C. La Vecchia
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Classification of image-enhanced endoscopy in colon tumors
One-Zoong Kim
Clinical Endoscopy.2025; 58(3): 337. CrossRef
Advantages of new generation colonoscopes on adenoma detection: A propensity-score matching study
Toshihiro Nishizawa, Osamu Toyoshima, Shuntaro Yoshida, Yoshiyuki Takahashi, Hideki Nakagawa, Hiroya Mizutani, Yosuke Kataoka, Takamitsu Kanazawa, Hirotoshi Ebinuma, Keisuke Hata
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
The Past, Present and Future of Imaging Enhanced Endoscopy in Colon Tumor
Kyueng-Whan Min, One-Zoong Kim
Journal of Digestive Cancer Research.2024; 12(2): 90. CrossRef
Texture and color enhancement imaging versus white light imaging for the detection of colorectal adenomas: Systematic review and meta-analysis
Stefan Mitev, Humza Saeed, Ch Faizan Rasheed, Abdullah, Stefan Murvakov, Vassil Sirakov, Stefan Tchernodrinski, Zoya Spassova
Endoscopy International Open.2024;[Epub] CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

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Quality indicators in colonoscopy: the chasm between ideal and reality: Su Bee Park, Jae Myung Cha; Clin Endosc 2022;55(3):332-338. Published online April 4, 2022; DOI: https://doi.org/10.5946/ce.2022.037

Abstract PDF PubReader ePub

Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

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Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
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Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Clinical Trial: Effect of Abdominal Vibration Combined With Walking Exercise Programme on Bowel Preparation in Older Patients With Constipation
Yuan‐Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Alimentary Pharmacology & Therapeutics.2025; 61(9): 1447. CrossRef
Innovative schemes of colonoscopy bowel preparation with oral lactulose: Optimizing traditional standards to improve colonoscopy quality
Josué Aliaga Ramos, Danilo Carvalho, Vitor Nunes Arantes
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
What are the priority quality indicators for colonoscopy in real‐world clinical practice?
Kasenee Tiankanon, Satimai Aniwan
Digestive Endoscopy.2024; 36(1): 30. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study
Josué Aliaga Ramos, Danilo Carvalho, Vitor N. Arantes
Clinical Endoscopy.2024; 57(6): 775. CrossRef
Bowel Preparation Agents: Balancing Efficacy for Colon Cleansing and Safety for Stomach Safety
Gwang Ha Kim
The Korean Journal of Gastroenterology.2024; 84(6): 293. CrossRef
A Systematic Review of Exercise Therapy for Bowel Preparation
Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Gastroenterology Nursing.2023; 46(5): 393. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

5,723 View
293 Download
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Original Article

Impact of Moderate versus Deep Sedation and Trainee Participation on Adenoma Detection Rate-Analysis of a Veteran Population: Hemnishil K. Marella, Nasir Saleem, Claudio Tombazzi; Clin Endosc 2021;54(2):250-255. Published online December 15, 2020; DOI: https://doi.org/10.5946/ce.2020.091

Abstract PDF PubReader ePub

Background
/Aims: The adenoma detection rate (ADR) is used as a quality indicator for screening and surveillance colonoscopy. The study aimed to determine if moderate versus deep sedation affects the outcomes of the ADR and other quality metrics in the veteran population.
Methods
A retrospective review of colonoscopies performed at Memphis Veterans Affairs Medical Center over a one-year period was conducted. A total of 900 colonoscopy reports were reviewed. After exclusion criteria, a total of 229 index, average-risk screening colonoscopies were identified. Data were collected to determine the impact of moderate (benzodiazepine plus opioids) versus deep (propofol) sedation on the ADR, polyp detection rate (PDR), and withdrawal time.
Results
Among 229 screening colonoscopies, 103 (44.9%) used moderate sedation while 126 (55%) were done under deep sedation. The ADR and PDR were not significantly different between moderate versus deep sedation at 35.9% vs. 37.3% (p=0.82) and 58.2% vs. 48.4% (p=0.13), respectively. Similarly, there was no significant difference in withdrawal time between moderate and deep sedation (13.4 min vs. 14 min, p=0.56) during screening colonoscopies.
Conclusions
In veterans undergoing index, average-risk screening colonoscopies, the quality metrics of the ADR, PDR, and withdrawal time are not influenced by deep sedation compared with moderate sedation.

Citations

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AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef
Patient Satisfaction, at What Cost?
Byron P. Vaughn
Clinical Gastroenterology and Hepatology.2022; 20(4): e912. CrossRef
Impact of sedation type on adenoma detection rate by colonoscopy
Hawraa Tarhini, Ayman Alrazim, Wissam Ghusn, Mohammad Hosni, Anthony Kerbage, Assaad Soweid, Ala-I Sharara, Fadi Mourad, Fadi Francis, Yasser Shaib, Kassem Barada, Fady Daniel
Clinics and Research in Hepatology and Gastroenterology.2022; 46(7): 101981. CrossRef
Safety, Efficacy and High-Quality Standards of Gastrointestinal Endoscopy Procedures in Personalized Sedoanalgesia Managed by the Gastroenterologist: A Retrospective Study
Marina Rizzi, Francesco Panzera, Demetrio Panzera, Berardino D’Ascoli
Journal of Personalized Medicine.2022; 12(7): 1171. CrossRef

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Review

Endocuff-Assisted Colonoscopy—A Novel Accessory in Improving Adenoma Detection Rate: A Review of the Literature: Rashmee Patil, Mel A. Ona, Emmanuel Ofori, Madhavi Reddy; Clin Endosc 2016;49(6):533-538. Published online May 2, 2016; DOI: https://doi.org/10.5946/ce.2016.032

Abstract PDF PubReader ePub

Endocuff (Arc Medical Design) is a U.S. Food and Drug Administration-approved device that is attached like a cap to the distal tip of the colonoscope; it is used to improve adenoma detection rates during colonoscopy. The aim of this review was to summarize and evaluate the clinical and technical efficacy of Endocuff in improving adenoma detection rate. A comprehensive literature review was performed to identify studies describing this technique. In this review article, we have summarized case series and reports describing Endocuff use and results. The reported indications, results, limitations, and complications are discussed.

Citations

Citations to this article as recorded by

Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
Clinical Endoscopy.2025; 58(1): 112. CrossRef
Endocuff Vision-Assisted Resection for Difficult Colonic Lesions—Preliminary Results of a Multicenter, Prospective Randomized Pilot Study
Rossella Palma, Gianluca Andrisani, Gianfranco Fanello, Augusto Lauro, Cristina Panetta, Chiara Eberspacher, Francesco Di Matteo, Samuele Vaccari, Noemi Zorzetti, Vito D’Andrea, Stefano Pontone
Journal of Clinical Medicine.2023; 12(15): 4980. CrossRef
Endocuff-assisted push enteroscopy increases the detection of proximal small-bowel gastrointestinal angiodysplasias
Christian S. Jackson, Chandrasekhar Kesavan, Anjali Das, Erick Imbertson, Richard M. Strong
Indian Journal of Gastroenterology.2022; 41(3): 300. CrossRef
Técnicas colonoscópicas para la detección de pólipos: un estudio egipcio
M. Abdelbary, S. Hamdy, H. Shehab, N. ElGarhy, M. Menesy, R. Marzaban
Revista de Gastroenterología de México.2021; 86(1): 36. CrossRef
Colonoscopic techniques in polyp detection: An Egyptian study
M. Abdelbary, S. Hamdy, H. Shehab, N. ElGarhy, M. Menesy, R. Marzaban
Revista de Gastroenterología de México (English Edition).2021; 86(1): 36. CrossRef
The Use of Attachment Devices to Aid in Adenoma Detection
Zoe Lawrence, Seth A. Gross
Current Treatment Options in Gastroenterology.2020; 18(1): 137. CrossRef
Number of significant polyps detected per six-minute withdrawal time at colonoscopy (SP6): a new measure of colonoscopy efficiency and quality
Rajaratnam Rameshshanker, Brian P Saunders
Frontline Gastroenterology.2020; 11(6): 491. CrossRef
EndoCuff‐assisted colonoscopy could improve adenoma detection rate: A meta‐analysis of randomized controlled trials
Hai Xu Jian, Bing Cheng Feng, Yan Zhang, Jun Yan Qu, Yue Yue Li, Xiu Li Zuo
Journal of Digestive Diseases.2019; 20(11): 578. CrossRef
Sessile Serrated Adenomas: How to Detect, Characterize and Resect
Michael X. Ma, Michael J. Bourke
Gut and Liver.2017; 11(6): 747. CrossRef
En este número
Enrique Murcio Pérez
Endoscopia.2016; 28(4): 135. CrossRef

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Focused Review Series: Endoscopic Screening and Surveillance for Gastrointestinal Cancer

Colon Cancer Screening with Image-Enhanced Endoscopy: Bong Min Ko; Clin Endosc 2014;47(6):504-508. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.504

Abstract PDF PubReader ePub

Colorectal cancer (CRC) is a major cause of cancer mortality worldwide, and this has led to an increased use of screening colonoscopy. This screening has resulted in long-term risk reduction in asymptomatic individuals. However, endoscopists may fail to detect advanced adenomas or colon cancer during screening. The reasons that adenomas or cancers are missed are thought to be associated with the location of the lesions or the skills of the endoscopist. To address the limitations of white light endoscopy (WLE) for adenoma detection, advanced endoscopic images have recently been used. Image-enhanced endoscopies (IEEs), including the use of topical dyes, optical filtering, and ultramagnification, allow for gastrointestinal lesion analysis. Many studies have compared the adenoma detection rate (ADR) obtained by using WLE and IEE, but with different results. IEE can be used to help the endoscopist to improve their ADR in screening colonoscopy. This review examines the possible roles of image-enhanced colonoscopy in CRC screening.

Citations

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Phthalocyanine-Blue Nanoparticles for the Direct Visualization of Tumors with White Light Illumination
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8,442 View
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