favor.
"Our future in endoscopy is in technology," says gastroenterologist
Vincent Jabour, MD, of the Wooster (Ohio) Ambulatory Surgery
Center. "It will lead us to better detection rates. Just look at how
much scopes have improved in the last 10 years. We've had a dramatic
improvement in terms of flexibility and visualization. Right now, most
of us are looking at a 180- to 240-degree view, and in time it will be an
even better view."
Although there are no adequate substitutes for training and consci-
entious technique, physicians now have more tools than ever to reach,
and even exceed, the ADR gold standard, which currently stands at
30% for male patients and 20% for females. ADR is defined as the per-
centage of first-time patients in which at least 1 adenoma has been
detected during a screening. Here are 4 trends that can help GI cen-
ters improve their ADR rate.
• Improved visualization. Just as it has in other areas of medicine,
high-definition imaging has turned endoscopists' world on its ear:
superior image quality for discovering and treating adenomas that
might otherwise have gone undetected; faster cecal intubation times;
and increased contrast for examining mucosal tissue. For example,
visualization systems that employ narrow band imaging (NBI) can
drive up ADR because NBI enhances the visibility of vessels and other
tissue on the mucosal surface.
Wide-angle and full-spectrum colonoscopes, as well as ancillary
devices with side-viewing cameras and powerful light sources, have
significantly expanded the effective view of the colon — as much as
330 degrees, compared to the standard 170-degree view of traditional
forward-viewing colonoscopes, which might not easily show adeno-
mas in mucosal folds. A 2015 study in the World Journal of
Gastroenterology showed that endoscopists achieved an ADR of 44%
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