Objective Colonoscopy is the accepted gold standard for screening of neoplastic colorectal lesions, but the substantial miss rate remains a challenge. Computed virtual chromoendoscopy with the Fujinon intelligent colour enhancement (FICE) system is a new dyeless imaging technique that might allow higher rates of adenoma detection.
Setting and Patients: This is a prospective randomized five tertiary care center trial of colonoscopy withdrawal in the FICE mode versus standard colonoscopy with targeted indigocarmine chromoscopy (control group) in consecutive patients attending for routine colonoscopy. Histopathology of detected lesions was confirmed by evaluation of endoscopic resection or biopsy specimens.
Results: A total of 871 patients were enrolled and 764 patients (344 female, mean age 64 years) were subjected to final analysis (368 in the FICE-group, 396 in the control group). In total, 236 adenomas (0.64 per case) were detected in the FICE group and 271 adenomas (0.68 per case) in the control group (p = 0.92). There was no statistically significant difference in the percent of patients with ≥ 1 adenoma between the control group (35.4 %) and FICE group (35.6 %) (p = 1.0). For the differential diagnosis of adenomas and non-neoplastic polyps, the sensitivity of FICE (92.7%) was comparable to that of indigocarmine (90.4 %) (p = 0.44).
Conclusions: At colonoscopy adenoma detection rates are not improved by virtual chromoendoscopy with the FICE system compared to white light endoscopy with targeted indigocarmine spraying. However, FICE can effectively substitute for chromoscopy in the determination of real-time histology.