Interim Results From A Prospective Multicentre Trial On Real Time Optical Diagnosis- Blast Study

Aims We aim to use Blue Light Imaging (BLI) for real time optical diagnosis during colonoscopy to see if it could meet the PIVI standards.

Methods It is a multicentre, prospective study. All endoscopists were trained in BASIC classification. Patients undergoing colonoscopy with 700 series colonoscopes (Fujifilm Co, Tokyo, Japan) on Eluxeo platform from Fujifilm were recruited in the study. Endoscopists were asked to make real time optical diagnosis of colorectal polyps using High Definition White Light (HDWL) and BLI. The accuracy, sensitivity, specificity, and negative predictive value of high-confidence optical diagnosis (adenoma vs. non-adenoma) by either BLI or HDWL for polyps up to 10mm was calculated.

Tab. 1 Colorectal polyps ≤ 10 mm (N= 370) 95 % CI

Accuracy	91.8 %	89.11 % to 95.17 %
Sensitivity	96.8 %	93.94 % to 98.64 %
Specificity	75.8 %	63.64 % to 85.46 %
NPV	86.2 %	75.71 % to 92.61 %

Results A total of 370 polyps ≤ 10mm were detected in 150 patients. The polyp sizes ranged from 1-10mm. 280 (75.6 %) polyps were diminutive (≤5mm) and 255 (68.9 %) were adenomas. 131(35.4 %) polyps ≤ 5mm were detected in the recto-sigmoid. The overall accuracy of BLI compared to HDWL was 91.9 % vs 88.9 % (p = 0.2). Overall 82.4 % polyps were diagnosed with high confidence with BLI compared to 77.4 % with HDWL.

The overall analysis of all polyps ≤10 mm is demonstrated in [tab. 1].

Further analysis of all colorectal diminutive polyps (N=280) demonstrated an accuracy of 89.3 %, sensitivity of 94.2 %, specificity of 77.1 % and NPV of 84.4 %.

Further sub group analysis of recto-sigmoid diminutive polyps (N= 131) demonstrated accuracy of 89.5 %, sensitivity of 95.8 %, specificity of 78.2 % and NPV of 90.9 %.

The overall post polypectomy surveillance interval was correctly predicted in 92.5 % patients according to ESGE guidelines.

Conclusions Real time diagnosis in trained endoscopists using HDWL and BLI along with BASIC meets both PIVI criteria for diminutive recto-sigmoid polyps.

Citation Hossain E, Abdelrahim M, Sharmila S et al. eP467 INTERIM RESULTS FROM A PROSPECTIVE MULTICENTRE TRIAL ON REAL TIME OPTICAL DIAGNOSIS- BLAST STUDY. Endoscopy 2021; 53: S251.

Publication History

Article published online:
19 March 2021