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    New Techniques, Cameras Improve Colonoscopy

    Technology Making Colonoscopy More Accurate

    Is High-Definition Better? continued...

    As the high-definition equipment was being phased in, DeVault's team assigned 1,200 patients to standard exams and another 1,200 to high-definition exams, then compared the detection rate of adenomas.

    ''Overall we found adenomas in about 30% who had high-definition and in 24% of those who had standard-definition colonoscopy," he says.

    But most were small, he says. High-definition is not available everywhere, he says, although the newer machines are now high-definition. So in time, the technology will be widespread.

    Tackling the Flat Lesion Problem

    In other research, Charles Kahi, MD, assistant professor of clinical medicine at Indiana University in Indianapolis, compared high-definition white light colonoscopy in 339 patients with ''chromocolonoscopy,'' in which a dye is sprayed to help improve detection of lesions, in 321 patients.

    Overall, the results of the dye technique were disappointing, he says. The differences in lesion detection were small. There was no increase in overall adenoma detection and there was a modest increase in flat and small adenoma detection.

    The results, he says, don't support chromocolonoscopy for average-risk patients.

    Message to Patients

    Although the newer technologies are not yet widespread, DuVault said it would make sense for patients scheduling a colonoscopy to at least ask their doctor about the availability of high-definition colonoscopies.

    Despite the bells and whistles, preparation of the colon by the patient before the test is still one of the key factors contributing to the accuracy of the test, doctors stressed. Other factors that have been shown to improve results include the experience of the physician performing the test.

    DeMarco says colonoscopy's effectiveness rate is good but that the new technology will improve detection more. "We are trying to make something that's [already] very good better."

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