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Endoscopy 2021; 53(08): 837-841
DOI: 10.1055/a-1258-8992
Innovations and brief communications

Computerized image analysis of blood vessels within mucosal defects for the prediction of delayed bleeding following colonic endoscopic mucosal resection: a pilot study

Yonatan Shaleve
1   Rappaport Faculty of Medicine, Technion, Haifa, Israel
,
Edmond Sabo
2   Carmel Medical Center, Haifa, Israel
,
Michael J. Bourke
3   Westmead Hospital, Sydney, Australia
,
Amir Klein
4   Rambam Healthcare Campus, Haifa, Israel
› Author AffiliationsTrial Registration: ClinicalTrials.gov Registration number (trial ID): NCT02000141 Type of study: Retrospective analysis of a prospectively collected database
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Author commentary on Yonatan Shaleve et al.Endoscopy 2021; 53(08): v42-v42
DOI: 10.1055/a-1289-7466

Abstract

Background Clinically significant post-endoscopic bleeding (CSPEB) is a common complication following colonic endoscopic mucosal resection (EMR). Current prediction tools are clinical and do not use the appearance of the post-EMR mucosal defect. We aimed to predict CSPEB by analyzing blood vessel morphology within the post-EMR mucosal defect.

Methods 43 patients with CSPEB were matched to 43 non-bleeders for clinical variables associated with CSPEB. Computerized image analysis quantified the morphologic characteristics of the blood vessels in the defect. Variables were measured in relation to the mucosal defect area. Multivariate analysis and a neural network (NNET) were used as prediction models.

Results The CSPEB group vessels had larger maximum diameter (113.07 vs. 69.03; P < 0.001), larger minimum radius (5.09 vs. 3.28; P = 0.002), larger perimeter value (337.82 vs. 193.86; P < 0.001), larger vessel length-of-outline (351.83 vs. 220.68; P = 0.002), and larger fractal dimension (1.11 vs. 1.10; P = 0.005) compared with non-bleeders. Discriminant analysis yielded 86 % sensitivity and 76.7 % specificity and an NNET classifier yielded 100 % sensitivity and 76.9 % specificity for identifying patients at risk.

Conclusions Blood vessel morphology in the post-EMR defect can be used to predict bleeding following colonic EMR.

Figs. 1s, 2s, Tables 1s, 2s



Publication History

Received: 08 March 2020

Accepted: 08 September 2020

Accepted Manuscript online:
08 September 2020

Article published online:
10 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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