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Taghiakbari M, Djinbachian R, Haumesser C, Sidani S, Chen Kiow JL, Panzini B, von Renteln D. Measuring Size of Colorectal Polyps Using a Virtual Scale Endoscope or Visual Assessment: A Randomized Controlled Trial. Am J Gastroenterol 2024; 119:1309-1317. [PMID: 38084850 DOI: 10.14309/ajg.0000000000002623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/26/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION This study aimed to compare the accuracy of polyp size measurements using a virtual scale endoscope (VSE) with an integrated laser-based adaptive scale function and visual assessment (VA) during colonoscopies. METHODS We conducted a single-blinded, prospective randomized controlled trial. Eligible patients (aged 45-80 years) undergoing screening, surveillance, or diagnostic colonoscopies were randomly assigned (1:1) into 2 groups. In the intervention group, all detected polyps were measured for size using VSE; in the control group, all polyps were measured using VA. Size measurements were compared with a reference standard of digital caliper measurement immediately post polypectomy. The primary outcome was the relative accuracy of real-time VSE measurement compared with VA. Secondary outcomes included the mean differences and the correlations between VSE or VA sizes and the reference standard of measurement. RESULTS Overall, 230 patients were enrolled and randomized. The relative size measurement accuracy of VSE was 84% in 118 polyps, which was significantly higher than that of VA (105 polyps; 68.4%, P < 0.001). VSE resulted in a significantly higher percentage of size measurements within 25% of true size compared with VA (81.4% vs 41%, P < 0.001). VSE had a significantly lower percentage for >5-mm polyps incorrectly sized as 1-5 mm compared with VA (13.5% vs 57.1%; P < 0.001) and a significantly lower percentage for >3-mm polyps incorrectly sized as 1-3 mm compared with VA (11.3% vs 56.5%; P < 0.001). DISCUSSION VSE significantly improves the size measurement accuracy of colorectal polyps during colonoscopies compared with VA and results in fewer misclassifications at relevant decision-making size thresholds.
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Affiliation(s)
- Mahsa Taghiakbari
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Roupen Djinbachian
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | | | - Sacha Sidani
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Jeremy Liu Chen Kiow
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Benoit Panzini
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Daniel von Renteln
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
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Popescu Crainic I, Djinbachian R, Rex DK, Barkun A, Shaukat A, East J, Hassan C, Mori Y, Pohl H, Rastogi A, Sharma P, Anderson JC, Taghiakbari M, Medawar E, von Renteln D. Expert endoscopist assessment of colorectal polyp size using virtual scale endoscopy, visual or snare-based estimation: a prospective video-based study. Scand J Gastroenterol 2024; 59:608-614. [PMID: 38333956 DOI: 10.1080/00365521.2024.2308519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND AIMS Accurate polyp size estimation during colonoscopy has an impact on clinical decision-making. A laser-based virtual scale endoscope (VSE) is available to allow measuring polyp size using a virtual adaptive scale. This study evaluates video-based polyp size measurement accuracy among expert endoscopists using either VSE or visual assessment (VA) with either snare as reference size or without any reference size information. METHODS A prospective, video-based study was conducted with 10 expert endoscopists. Video sequences from 90 polyps with known reference size (fresh specimen measured using calipers) were distributed on three different slide sets so that each slide set showed the same polyp only once with either VSE, VA or snare-based information. A slide set was randomly assigned to each endoscopist. Endoscopists were asked to provide size estimation based on video review. RESULTS Relative accuracies for VSE, VA, and snare-based estimation were 75.1% (95% CI [71.6-78.5]), 65.0% (95% CI [59.5-70.4]) and 62.0% (95% CI [54.8-69.0]), respectively. VSE yielded significantly higher relative accuracy compared to VA (p = 0.002) and to snare (p = 0.001). A significantly lower percentage of polyps 1-5 mm were misclassified as >5 mm using VSE versus VA and snare (6.52% vs. 19.6% and 17.5%, p = 0.004) and a significantly lower percentage of polyps >5 mm were misclassified as 1-5 mm using VSE versus VA and snare (11.4% vs. 31.9% and 14.9%, p = 0.038). CONCLUSIONS Endoscopists estimate polyp size with the highest accuracy when virtual adaptive scale information is displayed. Using a snare to assist sizing did not improve measurement accuracy compared to displaying visual information alone.
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Affiliation(s)
- Ioana Popescu Crainic
- Division of Gastroenterology, Montreal University Hospital Research Center, Montreal, Québec, Canada
| | - Roupen Djinbachian
- Division of Gastroenterology, Montreal University Hospital Research Center, Montreal, Québec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Québec, Canada
| | - Douglas K Rex
- Division of Gastroenterology and Hepatology, IN University Medical Center, Indianapolis, Indiana, USA
| | - Alan Barkun
- Division of Gastroenterology, McGill University Health Centre (MUHC), Montreal, Québec, Canada
| | - Aasma Shaukat
- Division of Gastroenterology and Hepatology, NYU Grossman School of Medicine, New York City, New York, USA
| | - James East
- Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, and Oxford NIHR Biomedical Research Centre, Oxford, UK
- Division of Gastroenterology and Hepatology, Mayo Clinic Healthcare, London, UK
| | - Cesare Hassan
- Division of Gastroenterology, Regina Margherita Hospital, Rome, Italy
| | - Yuichi Mori
- Division of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Heiko Pohl
- Division of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Division of Gastroenterology, White River Junction Veteran Affairs Medical Center, White River Junction, Vermont, USA
| | - Amit Rastogi
- Division of Gastroenterology, University of KS School of Medicine, Kansas City, Kansas, USA
| | - Prateek Sharma
- Division of Gastroenterology, University of KS School of Medicine, Kansas City, Kansas, USA
- Division of Gastroenterology, Veterans Affairs Medical Center, Kansas City, Missouri, USA
| | - Joseph C Anderson
- Division of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Mahsa Taghiakbari
- Division of Gastroenterology, Montreal University Hospital Research Center, Montreal, Québec, Canada
| | - Edgard Medawar
- Division of Gastroenterology, Montreal University Hospital Research Center, Montreal, Québec, Canada
| | - Daniel von Renteln
- Division of Gastroenterology, Montreal University Hospital Research Center, Montreal, Québec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Québec, Canada
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Kaufman D, Djinbachian R, Taghiakbari M, Popescu Crainic I, Haumesser C, Abou Khalil M, Sidani S, Liu Chen Kiow J, Panzini B, von Renteln D. A Preclinical Blinded Randomized-Controlled Trial Evaluating the Clinical Relevance of Polyp Size Measurement Using a Virtual Scale Endoscope. J Can Assoc Gastroenterol 2024; 7:149-153. [PMID: 38596804 PMCID: PMC10999760 DOI: 10.1093/jcag/gwad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background The virtual scale endoscope (VSE) helps endoscopists measure colorectal polyp size more accurately compared to visual assessment (VA). However, previous studies were not adequately powered to evaluate the sizing of polyps at clinically relevant size thresholds and relative accuracy for size subgroups. Methods We created 64 artificial polyps of varied sizes and Paris class morphology, randomly assigned 1:1 to be measured (383 total measurement datapoints with VSE and VA by 6 endoscopists blinded to true size) in a colon model. We added data from two previous trials (480 measurement datapoints). We evaluated for correct classification of polyps into size groups at 3 mm, 5 mm, 10 mm, and 20 mm size thresholds and the relative size measurement accuracy for diminutive polyps (≤5 mm), small polyps (5-9 mm), large polyps at 10-19 mm, and polyps (≥20). Results VSE had significantly less size group misclassifications at the 5 mm, and 10 mm thresholds (28 percent vs. 45 percent, P = 0.0159 and 26 percent vs. 44 percent, P = 0.0135, respectively). For the 3 mm and 20 mm thresholds, VSE had lower misclassifications; however, this was not statistically significant (36 percent vs. 46 percent, P = 0.3853 and 38 percent vs. 41 percent, P = 0.2705, respectively). The relative size measurement accuracy was significantly higher for VSE compared to VA for all size subgroups (diminutive (P < 0.01), small polyps (P < 0.01), 10-19 mm (P < 0.01), and ≥20 mm (P < 0.01)). Conclusion VSE outperforms VA in categorizing polyps into size groups at the clinically relevant size thresholds of 5 mm and 10 mm. Using VSE resulted in significantly higher relative measurement accuracy for all size subgroups.
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Affiliation(s)
- Daniel Kaufman
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- University of Montreal Medical School, Montreal, QC, Canada
| | - Roupen Djinbachian
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Mahsa Taghiakbari
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Ioana Popescu Crainic
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- University of Montreal Medical School, Montreal, QC, Canada
- Department of Internal Medicine, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Claire Haumesser
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- University of Montreal Medical School, Montreal, QC, Canada
| | - Maria Abou Khalil
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Sacha Sidani
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Jeremy Liu Chen Kiow
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Benoit Panzini
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
| | - Daniel von Renteln
- Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada
- Department of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, QC, Canada
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Djinbachian R, Taghiakbari M, Mubaid F, Rekkabi CY, Noorah BN, von Renteln D. Establishing ground truth of polyp size, morphology, and volume using three-dimensional scanning. Endoscopy 2024; 56:314-315. [PMID: 38547875 PMCID: PMC10978101 DOI: 10.1055/a-2248-1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Affiliation(s)
- Roupen Djinbachian
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Mahsa Taghiakbari
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Firas Mubaid
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Chakib Yahia Rekkabi
- Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Bibi Nuzha Noorah
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Daniel von Renteln
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
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Mori Y. New horizons in polyp size estimation. Endoscopy 2024; 56:271-272. [PMID: 38216131 DOI: 10.1055/a-2224-0756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Affiliation(s)
- Yuichi Mori
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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Wang J, Li Y, Chen B, Cheng D, Liao F, Tan T, Xu Q, Liu Z, Huang Y, Zhu C, Cao W, Yao L, Wu Z, Wu L, Zhang C, Xiao B, Xu M, Liu J, Li S, Yu H. A real-time deep learning-based system for colorectal polyp size estimation by white-light endoscopy: development and multicenter prospective validation. Endoscopy 2024; 56:260-270. [PMID: 37827513 DOI: 10.1055/a-2189-7036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND The choice of polypectomy device and surveillance intervals for colorectal polyps are primarily decided by polyp size. We developed a deep learning-based system (ENDOANGEL-CPS) to estimate colorectal polyp size in real time. METHODS ENDOANGEL-CPS calculates polyp size by estimating the distance from the endoscope lens to the polyp using the parameters of the lens. The depth estimator network was developed on 7297 images from five virtually produced colon videos and tested on 730 images from seven virtual colon videos. The performance of the system was first evaluated in nine videos of a simulated colon with polyps attached, then tested in 157 real-world prospective videos from three hospitals, with the outcomes compared with that of nine endoscopists over 69 videos. Inappropriate surveillance recommendations caused by incorrect estimation of polyp size were also analyzed. RESULTS The relative error of depth estimation was 11.3% (SD 6.0%) in successive virtual colon images. The concordance correlation coefficients (CCCs) between system estimation and ground truth were 0.89 and 0.93 in images of a simulated colon and multicenter videos of 157 polyps. The mean CCC of ENDOANGEL-CPS surpassed all endoscopists (0.89 vs. 0.41 [SD 0.29]; P<0.001). The relative accuracy of ENDOANGEL-CPS was significantly higher than that of endoscopists (89.9% vs. 54.7%; P<0.001). Regarding inappropriate surveillance recommendations, the system's error rate is also lower than that of endoscopists (1.5% vs. 16.6%; P<0.001). CONCLUSIONS ENDOANGEL-CPS could potentially improve the accuracy of colorectal polyp size measurements and size-based surveillance intervals.
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Affiliation(s)
- Jing Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ying Li
- Department of Endoscopy, Eighth Hospital of Wuhan, Wuhan, China
| | - Boru Chen
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Du Cheng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fei Liao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tao Tan
- Department of Endoscopy, Third People's Hospital of Hubei Province, Wuhan, China
| | - Qinghong Xu
- Department of Endoscopy, Eighth Hospital of Wuhan, Wuhan, China
| | - Zhifeng Liu
- Department of Endoscopy, Third People's Hospital of Hubei Province, Wuhan, China
| | - Yuan Huang
- Department of Endoscopy, Eighth Hospital of Wuhan, Wuhan, China
| | - Ci Zhu
- Department of Endoscopy, Eighth Hospital of Wuhan, Wuhan, China
| | - Wenbing Cao
- Department of Endoscopy, Eighth Hospital of Wuhan, Wuhan, China
| | - Liwen Yao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhifeng Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lianlian Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chenxia Zhang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bing Xiao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ming Xu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Liu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuyu Li
- Department of Endoscopy, Third People's Hospital of Hubei Province, Wuhan, China
| | - Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Key Laboratory of Digestive System, Renmin Hospital of Wuhan University, Wuhan, China
- Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province, Renmin Hospital of Wuhan University, Wuhan, China
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Djinbachian R, Popescu Crainic I, Pioche M, Saito Y, Sethi A, Chiu P, Marks J, Sebajang H, Pawlak K, Chennouf A, Benard F, Ide Y, Dang F, von Renteln D. Accuracy in Polyp Size Measurement Among Surgeons, Gastroenterologists, Trainees, and Experts: A Prospective Video-Based Study. Am J Gastroenterol 2024; 119:532-538. [PMID: 37713525 DOI: 10.14309/ajg.0000000000002494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/25/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Polyp size determination plays an important role in endoscopic decision making and follow-up determination. However, there is a lack of knowledge of endoscopist accuracy for polyp sizing and efficacy of available tools for size measurement. Our aim was to compare the accuracy of visual assessment, snare, forceps, and virtual scale endoscope (VSE) in estimating polyp size among a diverse group of endoscopists. METHODS We conducted a prospective video-based study. One hundred twenty polyps measured and recorded along with all available measurement tools were randomized to visual assessment, snare, forceps, or VSE group. Eleven endoscopists conducted video-based measurement using the randomized measurement tool. Primary outcome was relative accuracy in polyp size measurement compared with caliper measurement immediately postresection. RESULTS One thousand three hundred twenty measurements were performed. VSE had statistically significantly higher relative accuracy when compared to forceps (79.3 vs 71.3%; P < 0.0001). Forceps had statistically significantly higher relative accuracy when compared to visual assessment (71.3 vs 63.6%; P = 0.0036). There was no statistically significant difference when comparing visual assessment and snare-based measurements (63.6 vs 62.8%; P = 0.797). Overall, 21.5% of polyps >5 mm were misclassified as ≤5 mm and 17.3% of polyps ≥10 mm were misclassified as <10 mm. VSE had the lowest percentage of polyps >5 mm misclassified as ≤5 mm (2.6%), polyps ≤5 mm misclassified as >5 mm (5.1%), and polyps <10 mm misclassified as ≥10 mm (1.7%). DISCUSSION Visual size estimation of polyps is inaccurate independently of training level, sex, and specialty. Size measurement accuracy can be improved using forceps and yields the highest relative accuracy when an adaptive scale technology is used.
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Affiliation(s)
- Roupen Djinbachian
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Ioana Popescu Crainic
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Internal Medicine, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Division, Edouard Herriot University Hospital, Hospices Civils de Lyon, France
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Amrita Sethi
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Philip Chiu
- Department of Surgery, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong
| | - Jeffrey Marks
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Herawaty Sebajang
- Division of Surgery, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Katarzyna Pawlak
- Division of Gastroenterology and Hepatology, University of Toronto, Toronto, Ontario, Canada
| | - Anas Chennouf
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Florence Benard
- Division of Surgery, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Yutaro Ide
- Showa University Northern Yokohama Hospital, Digestive Disease Center, Yokohama, Japan
| | - Frances Dang
- Division of Gastroenterology and Hepatology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel von Renteln
- Montreal University Hospital Research Center, Montreal, Quebec, Canada
- Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
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Djinbachian R, Taghiakbari M, Mubaid F, Rekkabi CY, Noorah BN, von Renteln D. Establishing ground truth of polyp size, morphology, and volume using three-dimensional scanning. Endoscopy 2023; 55:E1260-E1261. [PMID: 38128592 PMCID: PMC10736104 DOI: 10.1055/a-2210-0635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Roupen Djinbachian
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Mahsa Taghiakbari
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Firas Mubaid
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Chakib Yahia Rekkabi
- Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - Bibi Nuzha Noorah
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
| | - Daniel von Renteln
- Gastroenterology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Gastroenterology, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
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Djinbachian R, Khellaf A, Noyon B, Soucy G, Nguyen BN, von Renteln D. Accuracy of measuring colorectal polyp size in pathology: a prospective study. Gut 2023; 72:2015-2018. [PMID: 37507216 DOI: 10.1136/gutjnl-2023-330241] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Roupen Djinbachian
- Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
- Gastroenterology, Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Abdelhakim Khellaf
- Pathology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Brandon Noyon
- Gastroenterology, Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Geneviève Soucy
- Pathology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Bich N Nguyen
- Pathology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
| | - Daniel von Renteln
- Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Quebec, Canada
- Gastroenterology, Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
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Baile-Maxía S, Jover R. Surveillance after colorectal polyp resection. Best Pract Res Clin Gastroenterol 2023; 66:101848. [PMID: 37852710 DOI: 10.1016/j.bpg.2023.101848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/12/2023] [Accepted: 07/02/2023] [Indexed: 10/20/2023]
Abstract
Post-polypectomy surveillance has proven to reduce colorectal cancer (CRC) incidence in patients with high-risk polyps, but it implies a major burden on colonoscopy units. Therefore, it should be targeted to individuals with a higher risk. Different societies have published guidelines on surveillance after resection of polyps, with notable discrepancies among them, and many recommendations come from low-quality evidence based on surrogate measures, such as risk of advanced adenoma, and not CRC risk. In this review, we aimed to summarize the evidence supporting post-polypectomy surveillance, compare the recently updated major guidelines, and discuss the existing discrepancies on this topic. Briefly, patients with adenomas ≥10 mm or high-grade dysplasia and patients with serrated polyps ≥10 mm or dysplasia are generally considered to have an increased risk of metachronous CRC and require surveillance, whereas the indication of surveillance is not clearly established in patients without these high-risk features.
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Affiliation(s)
- Sandra Baile-Maxía
- Gastroenterology Department, Hospital General Universitario Dr. Balmis, Instituto de Investigación Biomédica ISABIAL, Universidad Miguel Hernández, Alicante, Spain
| | - Rodrigo Jover
- Gastroenterology Department, Hospital General Universitario Dr. Balmis, Instituto de Investigación Biomédica ISABIAL, Universidad Miguel Hernández, Alicante, Spain.
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