MegaPixels - Does It Really Matter in Screening Colonoscopy?

Abstract

Purpose: High definition (HD) colonoscopy with a 1.25 megapixel image has the potential to identify more polyps, which could be missed during a standard (SD) colonoscopy. This advantage may be important in screening high risk patients. Its utility in average risk screening colonoscopy has shown variable results. Methods: 545 consecutive patients undergoing average risk screening colonoscopy with two experienced gastroenterologists over a six month period in one endoscopy center were included. 207 patients were examined with a standard scope and monitor (Olympus PCF-160AL)in the initial 3 months. 338 patients were examined with a high definition scope and 26 inch HD monitor (Pentax EC-3890Li HD) in the later 3 months. Patients with history of polyps, family history of colorectal neoplasia, inflammatory bowel disease, and those referred for reasons other than screening were excluded. Results: Both groups were well matched in age (mean age 56 vs 57 yrs), but the SD group had more females (66% vs 50.8%). A total of 77 (37%) patients had at least one polyp detected during standard colonoscopy vs 125 (37%) of patients with high definition colonoscopy. 38 (18%) patients had at least 1 adenoma detected on standard colonoscopy vs 89 (26.3%) of patients undergoing high definition colonoscopy. The adenoma detection rate between the two groups was statistically significant (p=0.027). Conclusion: High definition colonoscopy with 1.25 MegaPixel resolution significantly improved adenoma detection rates in our average risk screening colonoscopy population. Our study is limited by a female preponderance in the SD group, lack of correction for quality of bowel preparation and retrospective nature. However investment in HD technology has the potential to improve quality.