The University of Toledo Translation Journal of Medical Sciences 
Gastroenterology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 05; 11(1):e1-e1 

Does I-Scan Improve Adenoma Detection 
Rate Compared to High-Definition 
Colonoscopy? A Systematic Review and 
Meta-Analysis 
Muhammad Aziz, MD 1*, Zohaib Ahmed1, Hossein Haghbin1, Asad Pervez1, 
Hemant Goyal1, Faisal Kamal1, Abdallah Kobeissy1, Ali Nawras1, Douglas G Adler2 

1Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 
2Director of Therapeutic Endoscopy and Director of Gastroenterology Fellowship 
Training Program University of Utah, School of Medicine, Salt Lake City, UT 84132 

*Corresponding author: Muhammad.Aziz@utoledo.edu

Published: 05 May 2023 

Background and study aims: Recent studies evaluated the impact of i-scan in improving the adenoma 
detection rate (ADR) compared to high-definition (HD) colonoscopy. We aimed to systematically 
review and analyze the impact of this technique. 

Methods: A thorough search of the following databases was undertaken: PubMed/Medline, EMBASE, 
Cochrane and Web of Science. Full-text RCTs and cohort studies directly comparing i-scan and HD 
colonoscopy were deemed eligible for inclusion. Dichotomous outcomes were pooled and compared 
using random effects model and DerSimonian-Laird approach. For each outcome, relative risk (RR), 95 
% confidence interval (CI), and P value was generated. P < 0.05 was considered statistically significant. 

Results: A total of five studies with six arms were included in this analysis. A total of 2620 patients 
(mean age 58.6 ± 7.2 years and female proportion 44.8 %) completed the study and were included in our 
analysis. ADR was significantly higher with any i-scan (RR: 1.20, [CI: 1.06-1.34], P = 0.003) compared 
to HD colonoscopy. Subgroup analysis demonstrated that ADR was significantly higher using i-scan 
with surface and contrast enhancement Gonly (RR: 1.25, [CI: 1.07-1.47], P = 0.004).  

Conclusion: I-scan has the potential to increase ADR using the surface and contrast enhancement 
method. Future studies evaluating other outcomes of interest such as proximal adenomas and serrated 
lesions are warranted. 

https://dx.doi.org/10.46570/utjms.vol11-2023-653 

https://dx.doi.org/10.46570/utjms.vol11-2023-653
mailto:Muhammad.Aziz@utoledo.edu