Advanced Endoscopic Technologies to Improve the Diagnosis of Colorectal Polyps

2022 ◽  
Author(s):  
Maria Daca Alvarez ◽  
Liseth Rivero-Sanchez ◽  
Maria Pellisé
Keyword(s):  
Gold Standard ◽  
Detection Rate ◽  
Colorectal Polyps ◽  
Diagnostic Colonoscopy ◽  
Risk Of Death ◽  
The Past ◽  
Technological Advances ◽  
Adenoma Detection ◽  
Neoplastic Lesions

AbstractColonoscopy is the gold standard for colorectal cancer (CRC) prevention. The main quality indicator of colonoscopy is the adenoma detection rate, which is inversely associated with the risk of interval CRC and the risk of death from this neoplasia. In the setting of CRC prevention, diagnostic colonoscopy has undergone a remarkable evolution in the past 20 years. Hand in hand with the implementation of CRC prevention programs and technological advances, we are now able to identify tiny and subtle neoplastic lesions and predict their histology with great efficiency. In this article, we briefly review the endoscopy technologies that can be used to improve the detection and characterization of colorectal polyps.

scholarly journals The “Difficult” Colorectal Polyps and Adenomas: Practical Aspects

2018 ◽  
Vol 37 (5) ◽  
pp. 394-399 ◽  
Author(s):  
László Herszényi
Keyword(s):  
Gold Standard ◽  
Detection Rate ◽  
Colorectal Polyps ◽  
Endoscopic Removal ◽  
Polyp Detection ◽  
Oncological Safety ◽  
Significant Challenge ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Life Threatening

Background: Colonoscopy is the gold standard for adenoma detection. All endoscopists who perform colonoscopy must by mandate be skilled to perform polypectomy. However, there are significant differences between endoscopists in terms of the polyp detection rate and in the effectiveness of polypectomy. Summary: Most polyps identified can be managed by conventional polypectomy and do not pose a significant challenge for resection to an adequately skilled and trained endoscopist. Up to 15% of polyps may be considered “difficult”, unsuitable for conventional endoscopic removal because of size, morphology, site, or access grade. Endoscopist-, patient- and polyp-specific viewpoints influence the management of difficult polyps. Advances in endoscopic resection techniques have led to extended indications for polypectomy. Conventional endoscopic removal of colorectal polyps is associated with a small but not negligible incidence of complications, most commonly bleeding and perforation. Advanced techniques for difficult polyps can potentially cause significant, even life-threatening complications. In addition, in the presence of “difficult” polyps, complications are more common. Key Messages: Multiple techniques are now available for the resection of difficult polyps. The endoscopist should individualize the appropriate approach for the treatment of difficult polyp in order to maximize oncological safety, efficacy and minimize complications and unnecessary surgery.

scholarly journals A felső és alsó endoszkópiák indikációja, a diagnózisok megoszlása és minőségi mutatók 2010–2011-ben a Semmelweis Egyetem I. Belgyógyászati Klinikáján

2016 ◽  
Vol 157 (52) ◽  
pp. 2074-2081
Author(s):  
Lóránt Gönczi ◽  
Zsuzsanna Kürti ◽  
Petra Golovics ◽  
Zsuzsanna Végh ◽  
Barbara Lovász ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Indicators ◽  
Esophageal Varices ◽  
Detection Rate ◽  
Colorectal Polyps ◽  
Male Gender ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
Endoscopic Findings ◽  
Adenoma Detection

Abstract: Introduction and aim: The aim was to assess the incidence of endoscopic findings based on the indication of the procedures in upper/lower endoscopies, and measuring quality indicators of colonoscopies at the 1st Department of Medicine, Semmelweis University, Budapest. Method: Data of 2987 patients (male/female:1361/1626, mean age: 60.7 years(y), SD: 16.7y) between 01.01.2010 and 31.12.2011 were analyzed. Both inpatient and outpatient records were collected. Results: Incidence of peptic ulcer disease, esophageal varices, gastric polyps and gastric cancer were 10.8%, 4.5%, 6.1%, 2.9% in upper endoscopies, respectively. In colonoscopies colorectal polyps, diverticulosis, colorectal cancer and IBD were found in 29.9%, 22.4%, 6.9%, 9.7%, respectively. In patients having upper endoscopy with GI bleeding indication, older age (p<0.001), male gender (p<0.001, OR: 1.64), acenocoumarol/heparin use (p<0,001, peptic ulcers and esophageal varices were more frequent (p<0.001, OR: 2.83 and p<0.001, OR: 2.79), while in colonoscopies colorectal cancer had higher incidence (p<0.001, OR:3.27). 81% of colonoscopies were complete. Causes of incomplete procedures were ineffective bowel preparation (38.2%), technical difficulties (25.1%) and strictures (20.5%). Conclusion: The endoscopic findings and quality indicators (adenoma detection rate, coecal intubation rate) were in line with that reported in published series. Orv. Hetil., 2016, 157(52), 2074–2081.

scholarly journals Surveying ADR knowledge and practices among US gastroenterologists

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Michael Peng ◽  
Douglas Rex, MD, MACG
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Online Survey ◽  
Screening Colonoscopy ◽  
Current Evidence ◽  
Serrated Polyps ◽  
The Past ◽  
Adenoma Detection ◽  
Age And Sex

Background:   The adenoma detection rate (ADR) is of primary importance to the quality of screening colonoscopy. An online survey was conducted to assess knowledge and practices on ADR.  Methods:  Paid questionnaire distributed by email. Eligible respondents were board certified gastroenterologists who perform >80 colonoscopies per month with 3 to 35 years after fellowship.  Results:  39% were unaware that ADR applies only to screening colonoscopies and 76% incorrectly answered that ADR includes sessile serrated polyps/adenomas.  51% of respondents incorrectly believe the threshold is set at 25% because 25% is a national ADR average. Many also believe the threshold depends on the patient population (current evidence suggests adjusting ADR for factors other than age and sex is unnecessary). 75% ranked ADR as highly important. 80% reported tracking ADR. A busy practice was the most common reason for not tracking ADR. Caps, chromoendoscopy, and good bowel preparation were viewed as valuable for improving ADR (this is true except for caps). HD colonoscopes and education were considered less valuable (although evidence suggests HD and education are associated with improved ADR). 57% reported not sharing ADR information with their patients, and 59% reported no patients in the past 6 months asking for their ADR. Conclusion:  The importance of ADR as a validated quality measure is well understood, but there are misconceptions among gastroenterologists regarding the definition and measurement of ADR and which methods are proven to increase ADR.  Patients are having very little impact on ADR measurement.

scholarly journals Can technology increase adenoma detection rate?

2018 ◽  
Vol 11 ◽  
pp. 1756283X1774631 ◽  
Author(s):  
Wee Sing Ngu ◽  
Colin Rees
Keyword(s):  
Colorectal Cancer ◽  
Gold Standard ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
The Third ◽  
Common Cancer ◽  
Adenoma Detection ◽  
Flat Adenomas ◽  
Standard Investigation ◽  
Device Technology

Colorectal cancer is the third most common cancer worldwide and the second most common cause of cancer-related death in Europe and North America. Colonoscopy is the gold standard investigation for the colon but is not perfect, and small or flat adenomas can be missed which increases the risk of patients subsequently developing colorectal cancer. Adenoma detection rate is the most widely used marker of quality, and low rates are associated with increased rates of post-colonoscopy colorectal cancer. Standards of colonoscopy and adenoma detection vary widely between different endoscopists. Interventions to improve adenoma detection rate are therefore required. Many devices have been purported to increase adenoma detection rate. This review looks at current available evidence for device technology to improve adenoma detection rate during colonoscopy.

scholarly journals Artificial intelligence for identification and characterization of colonic polyps

2021 ◽  
Vol 14 ◽  
pp. 263177452110146
Author(s):  
Nasim Parsa ◽  
Michael F. Byrne
Keyword(s):  
Artificial Intelligence ◽  
Colorectal Cancer ◽  
Computer Aided Design ◽  
Colorectal Polyps ◽  
Optical Biopsy ◽  
Machine Learning Techniques ◽  
Withdrawal Time ◽  
Adenoma Detection ◽  
Computer Aided

Colonoscopy remains the gold standard exam for colorectal cancer screening due to its ability to detect and resect pre-cancerous lesions in the colon. However, its performance is greatly operator dependent. Studies have shown that up to one-quarter of colorectal polyps can be missed on a single colonoscopy, leading to high rates of interval colorectal cancer. In addition, the American Society for Gastrointestinal Endoscopy has proposed the “resect-and-discard” and “diagnose-and-leave” strategies for diminutive colorectal polyps to reduce the costs of unnecessary polyp resection and pathology evaluation. However, the performance of optical biopsy has been suboptimal in community practice. With recent improvements in machine-learning techniques, artificial intelligence–assisted computer-aided detection and diagnosis have been increasingly utilized by endoscopists. The application of computer-aided design on real-time colonoscopy has been shown to increase the adenoma detection rate while decreasing the withdrawal time and improve endoscopists’ optical biopsy accuracy, while reducing the time to make the diagnosis. These are promising steps toward standardization and improvement of colonoscopy quality, and implementation of “resect-and-discard” and “diagnose-and-leave” strategies. Yet, issues such as real-world applications and regulatory approval need to be addressed before artificial intelligence models can be successfully implemented in clinical practice. In this review, we summarize the recent literature on the application of artificial intelligence for detection and characterization of colorectal polyps and review the limitation of existing artificial intelligence technologies and future directions for this field.

scholarly journals Histopathology of Polyps and Its Clinical Correlation in Sample of Iraqi Patients Undergoing Colonoscopic Examination

2021 ◽  
Vol 13 (4) ◽  
pp. 106
Author(s):  
Khalid Abdulla Al-Khazraji ◽  
Mohammed Kamal Hashim ◽  
Mahmood Kamal Hashim ◽  
Wissam Khudhair Abbas ◽  
Mohammed Mousa Dhahir
Keyword(s):  
Detection Rate ◽  
Tertiary Care ◽  
Distal Colon ◽  
Colorectal Polyps ◽  
Adenoma Detection Rate ◽  
Polyp Detection ◽  
Cross Sectional ◽  
Colonoscopic Examination ◽  
Polyp Detection Rate ◽  
Adenoma Detection

BACKGROUND /AIMS: Colorectal cancer is the third most common cancer in 2018, the objective of our study was to describe the types and patterns of colorectal polyps in patients presenting to a tertiary care referral center in Baghdad. We also assessed the polyp detection rate (PDR) and adenoma detection rate (ADR). PATIENTS &amp; METHODS: This is single-institution, descriptive cross-sectional study of consenting 103 patients who had colonoscopy done at the Endoscopy Unit of Baghdad teaching hospital, IRAQ from the 1st of June 2018 to 31st of March 2019 after taking verbal consent, The data collected included: Age, sex, Family history of colorectal malignancies and indication for the current colonoscopy. RESULTS: One thousand and thirty patients were included in the study with a mean age of 44 years (SD = 16), with 560 males representing 54.4% and 470 females representing 45.66%.The polyp detection rate in colonoscopies was 19.4% and the adenoma detection rate was 13.6%. Polyps were found and removed in 200 patients, 40% of the removed polyps were tubular adenomas, tubulovillous adenomas in 20%, villous adenomas in 10%, hyperplastic polyps in 5%. The majority of the polyps were in the distal colon in 80% of patients with polyps. CONCLUSIONS: The polyp detection rate was (19.4%) and adenoma detection rate was (13.6%). The majority of polyps were detected in distal colon.

scholarly journals Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopy ◽  
2021 ◽  
Author(s):  
Britt B. S. L. Houwen ◽  
Cesare Hassan ◽  
Veerle M. H. Coupé ◽  
Marjolein J. E. Greuter ◽  
Yark Hazewinkel ◽  
...  
Keyword(s):  
Gold Standard ◽  
Literature Search ◽  
Gastrointestinal Endoscopy ◽  
Colorectal Neoplasia ◽  
Position Statement ◽  
Colorectal Polyps ◽  
Optical Diagnosis ◽  
High Confidence ◽  
Level Of Agreement

Abstract Background The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position Statement of the ESGE aiming to define simple, safe, and easy-to-measure competence standards for endoscopists and artificial intelligence systems performing optical diagnosis of diminutive colorectal polyps (1 – 5 mm). Methods A panel of European experts in optical diagnosis participated in a modified Delphi process to reach consensus on Simple Optical Diagnosis Accuracy (SODA) competence standards for implementation of the optical diagnosis strategy for diminutive colorectal polyps. In order to assess the clinical benefits and harms of implementing optical diagnosis with different competence standards, a systematic literature search was performed. This was complemented with the results from a recently performed simulation study that provides guidance for setting alternative competence standards for optical diagnosis. Proposed competence standards were based on literature search and simulation study results. Competence standards were accepted if at least 80 % agreement was reached after a maximum of three voting rounds. Recommendation 1 In order to implement the leave-in-situ strategy for diminutive colorectal lesions (1–5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 90 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1–5 mm in the rectosigmoid. Histopathology is used as the gold standard.Level of agreement 95 %. Recommendation 2 In order to implement the resect-and-discard strategy for diminutive colorectal lesions (1–5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 80 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1–5 mm. Histopathology is used as the gold standard.Level of agreement 100 %. Conclusion The developed SODA competence standards define diagnostic performance thresholds in relation to clinical consequences, for training and for use when auditing the optical diagnosis of diminutive colorectal polyps.

scholarly journals A Clinicopathological Review of Colonic Polyps in a Tertiary Hospital in North Central Nigeria

2018 ◽  
Vol 13 (4) ◽  
pp. 277 ◽  
Author(s):  
Matthew O. Bojuwoye ◽  
Abdulfatai B. Olokoba ◽  
James A. Ogunmodede ◽  
Sulaiman A. Agodirin ◽  
Olatunde O. K. Ibrahim ◽  
...  
Keyword(s):  
Detection Rate ◽  
Colonic Polyps ◽  
Tertiary Hospital ◽  
Colorectal Polyps ◽  
Colorectal Carcinomas ◽  
Polyp Detection ◽  
North Central ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The University

Background: Colorectal polyps, especially adenomas, are known as precursors of colorectal carcinomas. This study was aimed at determining the prevalence and histopathologic characteristics of colonic polyps among Nigerians that underwent colonoscopy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The authors also determined the polyp detection rate and adenoma detection rate. 

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