Impact of Full Spectrum Endoscopy® (Fuse®, EndoChoice®) on adenoma detection: a prospective French pilot study

Abstract

BackgroundCurrently, colonoscopy and polypectomy are the gold standard methods for the prevention of incident cases of colorectal cancer. The use of a new colonoscope (Fuse®, EndoChoice®) with a larger view of up to 330° appears to improve the adenoma detection rate (ADR). We performed a prospective observational study concerning this scope. The primary endpoint was potentially omitted adenomas (POA), i.e. adenomas seen on the side screens that will not appear on the central display during colonoscopy withdrawal without oriented movements. Secondary endpoints included our ADR, Fuse® impact on ADR, time to cecal intubation and withdrawal time.MethodsWe performed a single-center prospective study in one French center. We enrolled patients over 18 years of age between January 2015 and March 2016.ResultsWe included 141 patients; 3 were excluded because their colonoscopies were incomplete. Our study included 78 men and 60 women (sex ratio 1.3). The mean age was 60.4 years. A total of 130 polyps were resected. In all, 88/130 were adenomas (68%) and 34/88 adenomas (39%) were POA. The mean time to cecum was 10 min, and the mean withdrawal time was 12 min. ADR was 35% for men and 31% for women. The estimated ADR without POA was 29% for men and 19% for women.ConclusionsThe Fuse® system appears to be safe and efficient. POA represented 39% of all adenomas. The impact of the panoramic view on the ADR was considered substantial. The main limitations are the lack of randomization and the absence of a control group.

Full spectrum endoscopy for an easy and adequate visualization of Vater’s papilla

“…The advent of a novel endoscopic platform, Full Spectrum Endoscopy ® (FUSE ® , EndoChoice Inc., Atlanta, Georgia, USA) that allows a panoramic field of view (245° for gastroscope, 330° for colonoscope), led to a revolution in the examination of GI regions that were previously considered as "invisible", such as the proximal side of colonic folds/flexures (6). It has been shown in literature that FUSE is superior to conventional colonoscopy, as it is associated to a reduction in overall and proximal colorectal adenoma miss rates (7,8). Similarly, the new upper GI endoscope represents a sophisticated technical innovation, as it allows an accurate inspection of both gastric and duodenal mucosa (including the peri-ampullary region) in a single procedure (9).…”

Deep-learning based reconstruction of the stomach from monoscopic video data

“…In order to compensate the 'key-hole' effect during an endoscopic examination of the GI tract, as e.g. the colon, multiple-view endoscopes such as 'third eye' endoscopes [9,10] or 'fullspectrum endoscopy' (FUSE)" [11,12] for these systems have improved, the acquired image data can still not be used for an image-based documentation of the endoscopic examination and the clinical report of type and location of a finding. Using the urinary bladder as an example of a hollow organ to be assessed and examined with an endoscope, it has recently been shown, that it is possible to provide a so-called 'endoscopic panorama' or 'endoscopic map' of the bladder directly during the endoscopic examination in real time [13,14], which can afterwards be used for an image-based documentation of the bladder-examination, see Figure 2.…”

Changes in Adenoma Detection Rate From Full-Spectrum Endoscopy to Standard Forward-Viewing Endoscopy

“…7 The estimated potentially omitted adenomas without the side-viewing cameras of FUSE has been shown to be 29% for men and 19% for women. 8 FUSE has also been shown to outperform conventional colonoscopy with right-colon scope retroflexion in the detection of missed adenomas, both overall and in the proximal colon, even when performed by experienced endoscopists. 9 Our group previously reported that FUSE increased overall center-wide ADR by 5.4% when compared with TFV in a real world community based setting.…”

“…The views provided by these imagers importantly include the proximal aspect of haustral folds, where more than 70% of missed lesions may be located 7. The estimated potentially omitted adenomas without the side-viewing cameras of FUSE has been shown to be 29% for men and 19% for women 8. FUSE has also been shown to outperform conventional colonoscopy with right-colon scope retroflexion in the detection of missed adenomas, both overall and in the proximal colon, even when performed by experienced endoscopists 9.…”