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CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2371-3693
Original article

Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences

Querijn N. E. van Bokhorst
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
,
Britt B. S. L. Houwen
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
,
Yark Hazewinkel
4   Department of Gastroenterology and Hepatology, Tergooi Medical Center, Hilversum, the Netherlands
,
Manon van der Vlugt
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
5   Department of Gastroenterology, Bergman Clinics, Amsterdam, the Netherlands
,
Hanneke Beaumont
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
5   Department of Gastroenterology, Bergman Clinics, Amsterdam, the Netherlands
,
Joep Grootjans
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
5   Department of Gastroenterology, Bergman Clinics, Amsterdam, the Netherlands
6   Oncode Institute, Amsterdam, the Netherlands
,
Arjan van Tilburg
7   Department of Pathology, Reinier de Graaf Gasthuis, Delft, the Netherlands
,
Paul Fockens
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
,
Patrick M. M. Bossuyt
8   Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
,
Evelien Dekker 
1   Department of Gastroenterology and Hepatology, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
2   Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
3   Cancer Center Amsterdam, Amsterdam, the Netherlands
5   Department of Gastroenterology, Bergman Clinics, Amsterdam, the Netherlands
,
on behalf of the SCALE EYE study group
› Author AffiliationsFujifilm CorporationUnrestricted research granthttp://dx.doi.org/10.13039/501100002424

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT05499546 Type of study: Video-based study
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Referred to by:

Colorectal polyp size measurement: can we trust our own eyes?Endoscopy eFirst
DOI: 10.1055/a-2401-6181

Abstract

Background Accurate polyp size measurement is important for polyp risk stratification and decision-making regarding polypectomy and surveillance. Recently, a virtual scale (VS) function has been developed that allows polyp size measurement through projection of an adaptive VS onto colorectal polyps during real-time endoscopy. We aimed to evaluate the VS in terms of variability and systematic differences.

Methods We conducted a video-based study with 120 colorectal polyps, measured by eight dedicated colorectal gastroenterologists (experts) and nine gastroenterology residents following endoscopy training (trainees). Three endoscopic measurement methods were compared: (1) visual, (2) snare and (3) VS measurement. We evaluated the method-specific variance (as measure of variability) in polyp size measurements and systematic differences between these methods.

Results Variance in polyp size measurements was significantly lower for VS measurements compared to visual and snare measurements for both experts (0.52 vs. 1.59 and 1.96, p < 0.001) and trainees (0.59 vs. 2.21 and 2.53, p < 0.001). VS measurement resulted in a higher percentage of polyps assigned to the same size category by all endoscopists compared to visual and snare measurements (experts: 69 % vs. 55 % and 59 %; trainees: 67 % vs. 51 % and 47 %) and reduced the maximum difference between individual endoscopists regarding the percentage of polyps assigned to the ≥ 10 mm size category (experts: 1.7 % vs. 10.0 % and 5.0 %; trainees: 2.5 % vs. 6.7 % and 11.7 %). Systematic differences between methods were < 0.5 mm.

Conclusions Use of the VS leads to lower polyp size measurement variability and more uniform polyp sizing by individual endoscopists compared to visual and snare measurements.

Supplementary material



Publication History

Received: 02 April 2024

Accepted after revision: 18 July 2024

Accepted Manuscript online:
23 July 2024

Article published online:
23 September 2024

© 2024. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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