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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] [What about the content of this article? (0)] [Affiliation(s)] [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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