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20 November 2014

New technology improves bowel view and detection rates of polyps

Advanced imaging technology that triples the field of view during colonoscopies has been shown to increase the detection rate of polyps by almost one-third (31.3%) in patients with inflammatory bowel disease (IBD).

The first of its kind in the southern hemisphere, Full Spectrum Endoscopy (FUSE) uses
three cameras to inspect the lining of the bowel providing a sweeping 330-degree view instead of a single forward-facing camera offering a 170 degree view of traditional colonoscopes.

Speaking at Australian Gastroenterology Week, Professor Rupert Leong from Gastroenterology & Liver Services at Concord Hospital, said IBD affects about 75,000 Australians and is rapidly increasing in young people.

Full spectrum colonoscopy has the potential to provide more effective surveillance for those patients who are at higher risk of developing bowel cancer after 10 years of colonic IBD.

Polyps are a risk factor for bowel cancer, but in IBD the pre-cancerous changes are more subtle, highlighted especially when a blue-dye is sprayed internally at the time of the colonoscopy. This dye-spray chromoendoscopy component was also included in Professor Leong’s ongoing study.

“Overseas, this new technology has already been shown to increase detection of bowel polyps.
Full spectrum endoscopy lowered the missed detection rate of bowel polyps from about
41 per cent with traditional colonoscopy to only 7 per cent,” he said.

“This means that FUSE could potentially change the bowel’s natural history by removing potential-cancer causing polyps and institute a more effective surveillance program.”

“We are now applying the technology to IBD where the flat lesions typical in IBD that may progress to cancer are harder to identify than sporadic polyps."

The Sydney study involved 24 patients with either Crohn’s disease or ulcerative colitis undergoing both standard and FUSE colonoscopy, back-to-back on the same day.

“Basically with three cameras and three monitors, full spectrum colonoscopy provides an almost panoramic view of the bowel,” Professor Leong said.

“Repeat surveillance colonoscopies drive a lot of the demand for colonoscopy in Australia. If we can safely increase the interval between colonoscopies then we can improve overall access for more people.”

Professor Leong said based on recently published Sydney data, about two per cent of IBD patients will develop bowel cancer after 10 years, about seven per cent after 20 years, and 10 per cent after 30 years.

AGW is the key conference of the Gastroenterological Society of Australia (GESA), the peak professional body for health professionals working in the disciplines of gastroenterology and hepatology.

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