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DOI: 10.1055/a-2371-3693
Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences
Fujifilm CorporationUnrestricted research granthttp://dx.doi.org/10.13039/501100002424Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT05499546 Type of study: Video-based study
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.
Publikationsverlauf
Eingereicht: 02. April 2024
Angenommen nach Revision: 18. Juli 2024
Accepted Manuscript online:
23. Juli 2024
Artikel online veröffentlicht:
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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References
- 1 Hassan C, Pickhardt PJ, Kim DH. et al. Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopy. Aliment Pharmacol Ther 2010; 31: 210-217
- 2 Lieberman D, Moravec M, Holub J. et al. Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography. Gastroenterology 2008; 135: 1100-1105
- 3 He X, Hang D, Wu K. et al. Long-term risk of colorectal cancer after removal of conventional adenomas and serrated polyps. Gastroenterology 2020; 158: 852-861.e854
- 4 Hassan C, Antonelli G, Dumonceau JM. et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – update 2020. Endoscopy 2020; 52: 687-700
- 5 Gupta S, Lieberman D, Anderson JC. et al. Recommendations for follow-up after colonoscopy and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115: 415-434
- 6 Ferlitsch M, Moss A, Hassan C. et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2017; 49: 270-297
- 7 Kaltenbach T, Anderson JC, Burke CA. et al. Endoscopic removal of colorectal lesions: recommendations by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115: 435-464
- 8 Rex DK, Kahi C, O’Brien M. et al. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc 2011; 73: 419-422
- 9 Houwen B, Hassan C, Coupé VMH. et al. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2022; 54: 88-99
- 10 Moug SJ, Vernall N, Saldanha J. et al. Endoscopists’ estimation of size should not determine surveillance of colonic polyps. Colorectal Dis 2010; 12: 646-650
- 11 de Vries AH, Bipat S, Dekker E. et al. Polyp measurement based on CT colonography and colonoscopy: variability and systematic differences. Eur Radiol 2010; 20: 1404-1413
- 12 Eichenseer PJ, Dhanekula R, Jakate S. et al. Endoscopic mis-sizing of polyps changes colorectal cancer surveillance recommendations. Dis Colon Rectum 2013; 56: 315-321
- 13 Chaptini L, Chaaya A, Depalma F. et al. Variation in polyp size estimation among endoscopists and impact on surveillance intervals. Gastrointest Endosc 2014; 80: 652-659
- 14 Anderson BW, Smyrk TC, Anderson KS. et al. Endoscopic overestimation of colorectal polyp size. Gastrointest Endosc 2016; 83: 201-208
- 15 Kim JH, Park SJ, Lee JH. et al. Is forceps more useful than visualization for measurement of colon polyp size?. World J Gastroenterol 2016; 22: 3220-3226
- 16 Sakata S, Klein K, Stevenson ARL. et al. Measurement bias of polyp size at colonoscopy. Dis Colon Rectum 2017; 60: 987-991
- 17 Haumesser C, Zarandi-Nowroozi M, Taghiakbari M. et al. Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: blinded randomized controlled trial. Dig Endosc 2022; 35: 638-644
- 18 von Renteln D, Djinbachian R, Zarandi-Nowroozi M. et al. Measuring size of smaller colorectal polyps using a virtual scale function during endoscopies. Gut 2023; 72: 417-420
- 19 Djinbachian R, Crainic IP, Pioche M. et al. Accuracy in polyp size measurement among surgeons, gastroenterologists, trainees and experts: a prospective video-based study. Am J Gastroenterol 2024; 119: 532-538
- 20 Taghiakbari M, Djinbachian R, Haumesser C. et al. Measuring size of colorectal polyps using a virtual scale endoscope or visual assessment: a randomized controlled trial. Am J Gastroenterol 2024; 119: 1309-1307
- 21 Djinbachian R, Taghiakbari M, Haumesser C. et al. Comparing size measurement of colorectal polyps using a novel virtual scale endoscope, endoscopic ruler or forceps: a preclinical randomized trial. Endosc Int Open 2023; 11: E128-E135
- 22 Yoshioka M, Sakaguchi Y, Utsunomiya D. et al. Virtual scale function of gastrointestinal endoscopy for accurate polyp size estimation in real-time: a preliminary study. J Biomed Opt 2021; 26: 096002
- 23 Shimoda R, Akutagawa T, Tomonaga M. et al. Estimating colorectal polyp size with a virtual scale endoscope and visual estimation during colonoscopy: prospective, preliminary comparison of accuracy. Dig Endosc 2022; 34: 1471-1477
- 24 Urbaniak GC, Plous S. Research randomizer (version 4.0). Accessed March 10 2023. https://www.randomizer.org/
- 25 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-310
- 26 Rex DK, Rabinovitz R. Variable interpretation of polyp size by using open forceps by experienced colonoscopists. Gastrointest Endosc 2014; 79: 402-407
- 27 Han SK, Kim H, Kim JW. et al. Usefulness of a colonoscopy cap with an external grid for the measurement of small-sized colorectal polyps: a prospective randomized trial. J Clin Med 2021; 10: 2365
- 28 Morales TG, Sampliner RE, Garewal HS. et al. The difference in colon polyp size before and after removal. Gastrointest Endosc 1996; 43: 25-28
- 29 Turner JK, Wright M, Morgan M. et al. A prospective study of the accuracy and concordance between in-situ and postfixation measurements of colorectal polyp size and their potential impact upon surveillance. Eur J Gastroenterol Hepatol 2013; 25: 562-567
- 30 Tran T, Sundaram CP, Bahler CD. et al. Correcting the shrinkage effects of formalin fixation and tissue processing for renal tumors: toward standardization of pathological reporting of tumor size. J Cancer 2015; 6: 759-766
- 31 Lam D, Kaneko Y, Scarlett A. et al. The effect of formalin fixation on resection margins in colorectal cancer. Int J Surg Pathol 2019; 27: 700-705
- 32 Sakata S, McIvor F, Klein K. et al. Measurement of polyp size at colonoscopy: a proof-of-concept simulation study to address technology bias. Gut 2018; 67: 206-208
- 33 Quinn MF. Relation of observer agreement to accuracy according to a two-receiver signal detection model of diagnosis. Med Decis Making 1989; 9: 196-206
- 34 van Bokhorst QNE, Houwen BBSL, Hazewinkel Y. et al. Advances in artificial intelligence and computer science for computer-aided diagnosis of colorectal polyps: current status. Endosc Int Open 2023; 11: E752-E767
- 35 Yu H, Wang J, Li Y. et al. A real-time deep learning-based system for colorectal polyp size estimation by white-light endoscopy: development and multicenter prospective validation. Endoscopy 2023;