Abstract
Backgroundi-Scan is a novel virtual chromoendoscopy system designed to enhance surface and vascular patterns to improve optical diagnostic performance. Numerous prospective studies have been done to evaluate the accuracy of i-Scan in differentiating colonic neoplasms from non-neoplasms. i-Scan could be an effective endoscopic technique for optical diagnosis of colonic polyps.ObjectiveOur aim of this study was to perform a meta-analysis of published data to establish the diagnostic accuracy of i-Scan for optical diagnosis of colonic polyps.MethodsWe searched PubMed, Medline, Elsevier ScienceDirect and Cochrane Library databases. We used a bivariate meta-analysis following a random effects model to summarize the data and plotted hierarchical summary receiver-operating characteristic (HSROC) curves. The area under the HSROC curve (AUC) serves as an indicator of the diagnostic accuracy.ResultsThe meta-analysis included a total of 925 patients and 2312 polyps. For the overall studies, the area under the HSROC curve was 0.96. The summary sensitivity was 90.4% (95%CI 85%-94.1%) and specificity was 90.9% (95%CI 84.3%-94.9%). In 11 studies predicting polyps histology in real-time, the summary sensitivity and specificity was 91.5% (95%CI 85.7%-95.1%) and 92.1% (95%CI 84.5%-96.1%), respectively, with the AUC of 0.97. For three different diagnostic criteria (Kudo, NICE, others), the sensitivity was 86.3%, 93.0%, 85.0%, respectively and specificity was 84.8%, 94.4%, 91.8%, respectively.ConclusionsEndoscopic diagnosis with i-Scan has accurate optical diagnostic performance to differentiate neoplastic from non-neoplastic polyps with an area under the HSROC curve exceeding 0.90. Both the sensitivity and specificity for diagnosing colonic polyps are over 90%.
Highlights
Colorectal carcinoma (CRC) is a major public health burden worldwide
Endoscopic diagnosis with i-Scan has accurate optical diagnostic performance to differentiate neoplastic from non-neoplastic polyps with an area under the hierarchical summary receiver-operating characteristic (HSROC) curve exceeding 0.90
Both the sensitivity and specificity for diagnosing colonic polyps are over 90%
Summary
Colorectal carcinoma (CRC) is a major public health burden worldwide. Colonoscopy has been widely accepted as the preferred modality for the early detection of CRC. About 90% of all colonic polyps are smaller than 1 cm in diameter and 80% are diminutive colon polyps ( 5 mm), which rarely have malignant potential, and more colonic polyps are identified during colonoscopy as the image resolution of instruments improved [3]. If a sufficiently accurate real-time optical diagnosis of polyps could be made, this may allow the application of a “resect and discard” strategy for neoplastic diminutive colon polyps, and the endoscopists to leave diminutive rectosigmoid hyperplastic polyps in situ [4,5,6] which have negligible malignant potential [7], to reduce pathology costs. I-Scan could be an effective endoscopic technique for optical diagnosis of colonic polyps Numerous prospective studies have been done to evaluate the accuracy of i-Scan in differentiating colonic neoplasms from nonneoplasms. i-Scan could be an effective endoscopic technique for optical diagnosis of colonic polyps
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