556 Accuracy and Inter-Rater Reliability in the Pre-Clinical Evaluation of Fluorescent Deoxyglucose As a Topical Contrast Agent for the Detection of Colonic Neoplasia During Confocal Imaging

Abstract

participation. FS was performed by specialist gastroenterologists in hospital endoscopy units. Bowel preparation was limited to a single enema self-administered at home 2 hours before FS. TCT was performed after low-volume bowel preparation (low-fiber diet + 1 laxative dose at the main meals, in the 3 days preceding TCT) and fecal tagging. CTC examinations were evaluated using a double reading paradigm in which CAD was the first reader (Iussich G, Correale L, Senore C, et al. Invest Radiol. 2014;49(3):173-82). All subjects detected with a polyp ≥ 6 mm at TCT and those with high-risk distal polyps at FS were referred for colonoscopy (TC). Results: The participation rate following the initial invitation and mail reminder was 30.4% (298/980) in the TCT and 27.0% (264/976) in the FS arm (RR: 1.12; 95%CI:0.98-1.29). Compliance was significantly higher among men invited for TCT (34.1%; 168/501) than among those invited for FS (26.6%; 121/464 RR: 1,28; 95%CI:1.05-1.46); no difference (TCT: 26.7%; FS: 27.4%; RR: 0.95; 95%CI:0.78-1.17) was observed among women. Out of 2674 subjects undergoing TCT screening in Proteus 1, 79 (3.0%) had an inadequate test and 265 (9.9%) were referred for TC; the corresponding figures among the 2743 FS screenees were 75 (2.7%) and 270 (10.1%). AN detection rate of FS and CTC was similar. Conclusion TCT showed a similar effectiveness and acceptability as FS in a population screening setting. Comparative cost-effectiveness data are needed to assess the role of screening TCT, but available data already suggest that it could represent a valuable option for screenees refusing TC, or, as a triage test, for those at increased risk for TC side effects (subjects on anticoagulant therapy or suffering with co-morbidities).