Introduction Surveillance endoscopy is crucial to the management of Barrett’s oesophagus to diagnose and treat dysplasia. Recent studies have confirmed that increased time of inspection of the Barrett’s mucosa increases detection rates. However increasing inspection time has both clinical and economic implications. Advanced imaging techniques like autofluoresence imaging (AFI) improves detection of dysplastic lesions, but little on known about the time taken to detect abnormalities with these modalities.
Methods We presented a series of endoscopic images of dysplastic lesions within the oesophagus to novice endoscopists on a computer screen. Each of the 10 lesions was presented in white light endoscopy (WLE) and AFI modes. The subjects reviewed these images in a random order with 10 seconds for each image. They were tasked with identifying the lesion as fast as possible and fixating on it for the duration of presentation. An eye tracking system (Grinbath eye tracker, College Station Texas) was used to record eye movements of the subjects and we calculated the amount of time it took to fixate on the lesion and the percentage attention time on each lesion.
Results A total of 26 novice endoscopists were recruited to the study, resulting in a total of 260 presentations of WLE images and 260 presentations of AFI images. The average time to fixation on the lesion was significantly less (p < 0.05) in AFI (5.47 seconds) compared to WLE (6.17). In addition, the percentage attention span on the lesion following detection was significantly greater for AFI (58.12%) than WLE (49.96) (p < 0.0005).
Conclusion AFI reduces time to detection in novice endoscopists and could be a valuable training tool for trainees to improve their skills in detecting dysplasa in a time efficient manner. Advanced imaging endoscopic techniques may therefore help trainee endoscopists more than experienced endoscopists.
Disclosure of Interest None Declared.