Adenoma Detection Rate of 3D Colonoscopy

Colorectal Cancer Clinical Trial

Official title:

Comparison of Adenoma Detection Rate Between Conventional Colonoscopy and 3D Colonoscopy: a Randomized Controlled Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05153746
• Other study ID #: 202109112DIPB
• Status: Recruiting
• Phase: N/A
• Start date: February 10, 2022
• Est. completion date: July 31, 2025

Study information

• Verified date: January 2023
• Source: National Taiwan University Hospital
• Contact: Li-Chun Chang, AP
• Phone: 09726-51258
• Email: lichunchang[@]ntu.edu.tw
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Adenoma detection rate (ADR) has been the most important quality indicator on colonoscopy because ADR was reversely related with CRC incidence and mortality. Several image enhanced technologies, such as narrow-band imaging (NBI) or linked colour imaging (LCI) had been proved to have ability to increase the ADR. 3D techonology, however, has not been validated on colonoscopy performance. Therefore, current study was to compare the ADR between new 3D colonoscopy and conventional 2D colonoscopy.

Description:

An accumulating body of evidence has shown that detection and resection of pre-cancerous adenoma by colonoscopy could effectively prevent colorectal cancer (CRC) and its related mortality. Among various colonoscopy quality indicators, such as cecal intubation rate, withdrawal time, and adenoma detection rate (ADR), ADR is the most important one and most closely associated with the subsequent risk of CRC. A recent study further demonstrated the improvement of ADR could reduce subsequent risk of CRC.

To be noted, among all colorectal neoplasm, non-polypoid lesions, such as flat or depressed lesions, carries higher likelihood to be overlooked during conventional colonoscopy and these overlooked lesions were the main etiology of post-colonoscopy colorectal cancer (PCCRC). Nowadays, several colonoscopy technologies had been developed to enhance the detection of colorectal adenoma such as using digital or dye-spray chromoendoscopy or add-on device such as Cap-assisted endoscopy. Among them, some had showed the potential to enhance the detection of non-polypoid lesion, for example, the next-generation NBI or iSCAN.

3D endoscopy is a new technology that using image processing technique to offer more information on tissue depth in comparison with conventional 2D endoscopy. The utility of 3D endoscopy on GI tract was mainly from upper GI tract and it was proved to enhance the diagnostic accuracy on superficial gastric tumors and shortened the procedure time during performing gastric endoscopic submucosal dissection(ESD). However, few is known that whether 3D colonoscopy could enhance the adenoma detection, especially for non-polypoid lesion detection, during colonoscopy examination. Therefore, this prospective, randomized control study is aim to demonstrate the efficacy of 3D colonoscopy on adenoma detection in comparison with conventional 2D colonoscopy.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 300
• Est. completion date: July 31, 2025
• Est. primary completion date: December 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years and older

Eligibility

Inclusion Criteria:

• Age 40 or above

• Indication for colonoscopy, including screening, surveillance, symptomatic, etc

Exclusion Criteria:

• Poor and inadequate bowel preparation

• Incomplete study because of obstructive lesion, including cancer, stenosis, etc.

• Failure of cecal intubation, difficult insertion

• Inflammatory bowel disease

• Hereditary polyposis, (FAP, Lynch syndrome, hyperplastic polyposis, etc.)

Related Conditions & MeSH terms

• Adenoma
• Colorectal Cancer
• Colorectal Neoplasms

Intervention

Device:
• 3D colonoscopy
3D colonoscopy is a new device to enhance endoscopic imaging.

Locations

Country	Name	City	State
Taiwan	National Taiwan University Hospital	Taipei

Sponsors (1)

Lead Sponsor	Collaborator
National Taiwan University Hospital

Country where clinical trial is conducted

Taiwan, 

References & Publications (8)

Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, Zauber AG, de Boer J, Fireman BH, Schottinger JE, Quinn VP, Ghai NR, Levin TR, Quesenberry CP. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014 Apr 3;370(14):1298-306. doi: 10.1056/NEJMoa1309086. — View Citation

Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, Zwierko M, Rupinski M, Nowacki MP, Butruk E. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010 May 13;362(19):1795-803. doi: 10.1056/NEJMoa0907667. — View Citation

Kaminski MF, Wieszczy P, Rupinski M, Wojciechowska U, Didkowska J, Kraszewska E, Kobiela J, Franczyk R, Rupinska M, Kocot B, Chaber-Ciopinska A, Pachlewski J, Polkowski M, Regula J. Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death. Gastroenterology. 2017 Jul;153(1):98-105. doi: 10.1053/j.gastro.2017.04.006. Epub 2017 Apr 17. — View Citation

Matsuda T, Ono A, Sekiguchi M, Fujii T, Saito Y. Advances in image enhancement in colonoscopy for detection of adenomas. Nat Rev Gastroenterol Hepatol. 2017 May;14(5):305-314. doi: 10.1038/nrgastro.2017.18. Epub 2017 Mar 15. — View Citation

Nomura K, Kaise M, Kikuchi D, Iizuka T, Fukuma Y, Kuribayashi Y, Tanaka M, Toba T, Furuhata T, Yamashita S, Matsui A, Mitani T, Hoteya S. Recognition Accuracy Using 3D Endoscopic Images for Superficial Gastrointestinal Cancer: A Crossover Study. Gastroenterol Res Pract. 2016;2016:4561468. doi: 10.1155/2016/4561468. Epub 2016 Aug 15. — View Citation

Nomura K, Kikuchi D, Kaise M, Iizuka T, Ochiai Y, Suzuki Y, Fukuma Y, Tanaka M, Okamoto Y, Yamashita S, Matsui A, Mitani T, Hoteya S. Comparison of 3D endoscopy and conventional 2D endoscopy in gastric endoscopic submucosal dissection: an ex vivo animal study. Surg Endosc. 2019 Dec;33(12):4164-4170. doi: 10.1007/s00464-019-06726-w. Epub 2019 Mar 6. — View Citation

Winawer SJ, Zauber AG, O'Brien MJ, Geenen J, Waye JD. The National Polyp Study at 40: challenges then and now. Gastrointest Endosc. 2021 Mar;93(3):720-726. doi: 10.1016/j.gie.2020.09.044. Epub 2020 Sep 30. No abstract available. — View Citation

Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687-96. doi: 10.1056/NEJMoa1100370. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Adenoma detection rate	The number of subjects with at least one adenomatous polyp found during the colonoscopy	1 week
Secondary	Proximal adenoma detection rate	The number of subjects with at least one adenomatous polyp found at proximal colon ( cecum, ascending colon and hepatic flexure) during the colonoscopy	1 weeks
Secondary	Sessile serrated adenoma detection rate	The number of subjects with at least one sessile serrated adenomatous polyp found during the colonoscopy	1 week
Secondary	Adenoma per colonoscopy (APC)	Average adenomatous polyps number found in each colonoscopy	1 week
Secondary	Flat adenoma detection rate	The number of subjects with at least one flat adenomatous polyp found during the colonoscopy	1 week