Prospective comparison of the novel full spectrum endoscopy (FUSE) and advanced high definition-white light endoscopy for detection of polyps in routine practice

Background and Aims: Despite major advances in white light endoscopy detection of colon polyps remains challenging with significant polyp miss rates. The novel second generation full spectrum endoscopy (FUSE) is a new scope with two additional cameras in the sides that provides a panoramic 330o field of view. The aim of this study is to identify the role of the FUSE in improving polyp detection. Methods: This was a single center, prospective, randomized, open label study in patients that presented for routine colonoscopy at an outpatient unit during a six months period. Patients were randomized to either FUSE (FUSE colonoscope CDVL slim c38) or standard frontal view (SFV) colonoscopy (Olympus Evis Exera III 190). The primary outcomes were polyp detection rates (PDR), diverticulum detection rate (DDR) and complete colonoscopy. Secondary outcomes were procedure time, adverse event rates, size and characteristics of the polyps and success of endoscopic treatment (R0 resection). All procedures were performed by experienced endoscopists, who had carried out > 5000 colonoscopies and had cecal intubation rates of > 95%. Results: A total of 197 patients (49,2% female, 50,8% male, median age 60 years, range ≥16 years) were studied. No significant difference was seen between the 2 groups for the primary endpoints of polyps detection rate (PDR), diverticulum detection rate (DDR) or complete colonoscopy (table 1). About secondary endpoints: R0 endoscopic resection was achieved in 95% in both groups (p=0,68). The median procedure time in minutes was higher with SFV (26,1 ± 13 min) than FUSE 21,5 +/‐ 10,7 min (‐4.6, IC95%: ‐8 a ‐1.2) (p=0,008). There were no significant differences regarding adverse events, determination of colon cleanliness, or others epidemiologic factors. 2 case were excluded of the statistical analysis due to surveillance of polyposis syndrome, to avoid skewing of results. Conclusions: In expert hands, PDR and DDR exceed 50% with advanced white light and FUSE systems. FUSE was not superior to advanced white light endoscopy for the PDR and DDR. However, with FUSE we can reduce procedure duration without any additional adverse events or increased discomfort. These data further demonstrate the safety and feasibility of the new FUSE system (Figure Presented).