New technologies and techniques to improve adenoma detection in colonoscopy

Figure 1 Cumulative hazard rates for interval colorectal cancer, according to the endoscopists adenoma detection rate. The graph shows cumulative hazard rates for interval colorectal cancer among subjects who underwent screening colonoscopy that was performed by an endoscopist with an ADR in one of the following categories: less than 11.0%, 11.0% to 14.9%, 15.0% to 19.9%, and 20.0% or more. ADR: Adenoma detection rate.

Figure 2 Relationship between start time of colonoscopy and adenoma detection, withdrawal time, caecal intubation, and bowel preparation quality.

Figure 3 Digital chromoendoscopy. A: Represents sessile adenoma seen in standard white light; B: Shows the same adenoma after the use of indigo carmine applied for chromoendoscopy; C: Shows further assessment of the adenoma using narrow band imaging (NBI).

Figure 4 Digital-auto-fluorescence. A demonstrates polyp in white light, whilst B represents the same area in digital-auto-fluorescence. The normal mucosa appears green, with the adenoma appearing white.

Figure 5 Example of the display module of the full spectrum endoscopy system and the 330° view (top). Bottom image is the full spectrum endoscopy scope demonstrating the side mounted camera and lights[27].

Figure 6 Confocal laser endomicroscopy of the colon using intravenous fluorescein. A: Colon carcinoma with total disorganization of cell architecture, invasion and destruction of the vessels with leakage of fluorescein (arrows); B: Severe inflammatory changes in ulcerative colitis with cellular infiltrate causing an increase in the distance between crypts and excessive vascularity (arrows)[63].

Figure 7 Third eye retroscope^®. A: Image of the third eye retroscope^® protruding from the working channel of the colonoscope; B: Forward view of third-eye retroscope^®; C: View from lens of third-eye retroscope^®[27] .