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CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2510-8759
Original article

Comparison of adenoma detection rate between three-dimensional and standard colonoscopy: a multicenter randomized controlled trial

Wei-Yuan Chang
1   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
2   Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
,
Wei-Chih Liao
1   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
3   Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
,
Li-Chun Chang
1   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
2   Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
,
Hsuan-Ho Lin
4   Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan
,
Pin-Ya Wei
4   Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan
,
Hsing-Chien Wu
5   Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
,
Han-Mo Chiu
1   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
2   Health Management Center, National Taiwan University Hospital, Taipei, Taiwan
,
Ming-Shiang Wu
1   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
3   Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
› InstitutsangabenGefördert durch: MedicalTek Co. Ltd, Taiwan.

Clinical Trial: Registration number (trial ID): NCT05153746, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Randomized, Multi-Center Study
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Abstract

Background

Improvement in adenoma detection rates (ADRs) effectively reduces the incidence of colorectal cancer. In a simulation study, three-dimensional (3D) colonoscopy provided more anatomical details than standard two-dimensional (2D) colonoscopy and improved ADR. We compared ADRs between 2D and 3D colonoscopy.

Methods

In this multicenter randomized controlled trial, participants aged ≥40 years undergoing colonoscopy for screening, surveillance, or symptoms between February 2022 and June 2023 were randomized 1:1 into 2D or 3D groups. The primary outcome was ADR. Secondary outcomes included detection rates for flat adenomas, right-sided adenomas, proximal adenomas, advanced adenomas, and sessile serrated lesions (SSLs).

Results

Of 348 participants recruited, data from 158 (2D group) and 160 (3D group) were analyzed. Mucosa inspection time was comparable between the 3D (9.8 [SD 2.6] minutes) and 2D (9.4 [SD 3.1] minutes) groups (P = 0.21). Compared with the 2D group, the 3D group had a significantly higher ADR (53.1% vs. 38.6%; difference 14.5% [95%CI 3.7 to 25.4]; P = 0.009), and higher detection rates for flat adenomas (35.0% vs. 21.5%; difference 13.5% [95%CI 3.7 to 23.3]; P = 0.008), right-sided adenomas (26.3% vs. 15.2%; difference 11.1% [95%CI 2.2 to 19.9]; P = 0.02), proximal adenomas (38.1% vs. 23.4%; difference 14.7% [95%CI 4.7 to 24.7]; P = 0.005), and adenomas sized 5–9 mm (45.0% vs. 31.0%; difference 14.0% [95%CI 3.4 to 24.5]; P = 0.01). There was no difference in detection rates for SSLs or advanced adenomas.

Conclusion

3D colonoscopy improved adenoma detection without significantly increasing the mucosa inspection time.



Publikationsverlauf

Eingereicht: 17. August 2024

Angenommen nach Revision: 29. November 2024

Accepted Manuscript online:
07. Januar 2025

Artikel online veröffentlicht:
28. Februar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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