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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E824-E831
DOI: 10.1055/a-1794-0346
Original article

Does i-scan improve adenoma detection rate compared to high-definition colonoscopy? A systematic review and meta-analysis

Muhammad Aziz
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Zohaib Ahmed
2   Department of Internal Medicine, University of Toledo, Toledo, Ohio, United States
,
Hossein Haghbin
3   Division of Gastroenterology, Ascension Providence Hospital, Southfield, Michigan, United States
,
Asad Pervez
4   Division of Gastroenterology and Hepatology, West Virginia University, Morgantown, West Virginia, United States
,
Hemant Goyal
5   Division of Gastroenterology and Hepatology, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
,
Faisal Kamal
6   Division of Gastroenterology, University of California, San Francisco, California, United States
,
Abdallah Kobeissy
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Ali Nawras
1   Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United States
,
Douglas G. Adler
7   Center for Advanced Therapeutic Endoscopy (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, Colorado, United States
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Abstract

Background and study aims Recent studies evaluated the impact of i-scan in improving the adenoma detection rate (ADR) compared to high-definition (HD) colonoscopy. We aimed to systematically review and analyze the impact of this technique.

Methods A thorough search of the following databases was undertaken: PubMed/Medline, EMBASE, Cochrane and Web of Science. Full-text RCTs and cohort studies directly comparing i-scan and HD colonoscopy were deemed eligible for inclusion. Dichotomous outcomes were pooled and compared using random effects model and DerSimonian-Laird approach. For each outcome, relative risk (RR), 95 % confidence interval (CI), and P value was generated. P < 0.05 was considered statistically significant.

Results A total of five studies with six arms were included in this analysis. A total of 2620 patients (mean age 58.6 ± 7.2 years and female proportion 44.8 %) completed the study and were included in our analysis. ADR was significantly higher with any i-scan (RR: 1.20, [CI: 1.06–1.34], P = 0.003) compared to HD colonoscopy. Subgroup analysis demonstrated that ADR was significantly higher using i-scan with surface and contrast enhancement only (RR: 1.25, [CI: 1.07–1.47], P = 0.004).

Conclusions i-scan has the potential to increase ADR using the surface and contrast enhancement method. Future studies evaluating other outcomes of interest such as proximal adenomas and serrated lesions are warranted.

Supplementary material



Publication History

Received: 31 October 2021

Accepted after revision: 24 January 2022

Article published online:
10 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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