scholarly journals A78 COMPARISON OF THE NICE, SANO, AND WASP CLASSIFICATIONS FOR OPTICAL DIAGNOSIS OF SMALL COLORECTAL POLYPS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 92-93
Author(s):  
R Djinbachian ◽  
H Pohl ◽  
E Marchand ◽  
P Marques ◽  
M Bouin ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Colorectal Polyps ◽  
Classification Systems ◽  
Optical Diagnosis ◽  
Polyp Detection ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Multiple Classification ◽  
Surveillance Interval ◽  
Adenoma Detection Rates

Abstract Background Optical diagnosis can be used as an alternative to pathology for the evaluation of colorectal polyps. There exist multiple classification systems that can be used to assist in performing optical diagnosis. Aims The aim of this study was to compare three different optical diagnosis classifications (NICE, SANO and WASP) when using Optivista and iScan image enhanced endoscopy (IEE). Methods The study included subjects between 45–80 years undergoing an elective screening, surveillance, or diagnostic colonoscopy with optical diagnosis using Optivista or iScan IEE. Three validated IEE scales (NICE, SANO and WASP classifications) were used for all optical diagnoses. Primary outcome was the agreement with pathology for surveillance intervals determined when using NICE, SANO and WASP for polyps 1-10mm. Secondary outcomes for polyps 1-10mm included accuracy of polyp diagnosis and negative predictive value (NPV) for rectosigmoid adenomas. Results A total of 399 patients were prospectively enrolled in the trial. The polyp detection and adenoma detection rates were 58.6% and 38.8% respectively. The proportion of correct surveillance interval assignment when at least one optical diagnosis was made was 92.9% when using NICE, 92.3% when using SANO, 89.5% when using WASP (p=0.656). Correct diagnosis was made for 74.2% of polyps when using NICE, 74.2% when using SANO, 65.6% when using WASP (p=0.012). The NPV for rectosigmoid adenomas was 91.2% when using NICE, 90.5% when using SANO, 87.5% when using WASP. Conclusions For optical diagnosis using Optivista and iScan IEE, all studied classifications performed equally for surveillance interval assignment. WASP had lower proportion of correct diagnoses on a polyp level and lower NPV for rectosigmoid adenomas. Funding Agencies None

Endocuff vision-assisted vs. standard polyp resection in the colorectum (the EVASTA study): a prospective randomized study

Endoscopy ◽  
2019 ◽  
Vol 52 (01) ◽  
pp. 45-51 ◽  
Author(s):  
Guido von Figura ◽  
Moritz Hasenöhrl ◽  
Bernhard Haller ◽  
Alexander Poszler ◽  
Jörg Ulrich ◽  
...  
Keyword(s):  
Randomized Study ◽  
Colorectal Polyps ◽  
University Hospital ◽  
Standard Group ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
Standard Colonoscopy ◽  
The Impact

Abstract Background Cap-assisted colonoscopy is frequently used to facilitate adenoma detection during endoscopy. However, data on how cap assistance influences polyp resection are scarce. We aimed to evaluate the impact of cap assistance with the Endocuff vision device (EVD) on the resection time for colorectal polyps in patients undergoing colonoscopy. Methods A randomized, prospective study was performed in a university hospital in Germany. A total of 250 patients were randomly assigned 1:1 to undergo either colonoscopy with the EVD (EVD arm) or standard colonoscopy without the use of a cap (standard arm). The primary outcome was the average duration of polypectomy. Secondary outcomes included adenoma detection rate, cecal and ileal intubation times, and propofol dosage. Results The use of EVD led to a significant reduction in the median polypectomy time in the EVD vs. standard arm (54 vs. 80 seconds, respectively; P = 0.02). This effect was strongest for polyps ≥ 6 mm. Compared with the standard group, Endocuff assistance also resulted in a shorter cecal intubation time (6 vs. 8 minutes; P = 0.03) and overall colonoscopy time (23 vs. 27 minutes; P = 0.02). In contrast, no difference in withdrawal time was observed. The polyp and adenoma detection rates did not differ significantly between the two groups. Conclusion Endocuff-assisted colonoscopy reduces the duration of polypectomy, which may be due to a more stable scope position during resection. Further studies are needed to investigate whether comparable effects will be seen for other interventions, such as clipping or biopsy sampling.

Are adenoma and serrated polyp detection rates correlated with endoscopists’ sensitivity of optical diagnosis?

Endoscopy ◽  
2020 ◽  
Vol 52 (09) ◽  
pp. 763-772 ◽  
Author(s):  
Maxime E. S. Bronzwaer ◽  
Jasper L. A. Vleugels ◽  
Sascha C. van Doorn ◽  
Marcel G. W. Dijkgraaf ◽  
Paul Fockens ◽  
...  
Keyword(s):  
Detection Rate ◽  
Lesion Detection ◽  
Optical Diagnosis ◽  
Polyp Detection ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Serrated Polyp ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Post Hoc

Abstract Introduction Endoscopists with a high adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSPDR) detect these polyps more frequently, which may be attributable to better recognition of their endoscopic features. Little is known about the association between endoscopic lesion detection and differentiation skills. Therefore, we evaluated the correlation between the ADR, PSPDR, and the sensitivity of optical diagnosis for adenomas and serrated polyps. Methods We performed an exploratory post-hoc analysis of the DISCOUNT-2 study, including complete colonoscopies after a positive fecal immunochemical test (FIT) performed by endoscopists who performed ≥ 50 colonoscopies. The correlations between the ADR, PSPDR, and the sensitivity of optical diagnosis were calculated using Pearson’s rho correlation coefficient. Results 24 endoscopists performed ≥ 50 colonoscopies, resulting in a total of 2889 colonoscopies. The overall ADR was 84.5 % (range 71.4 % – 95.3 %) and overall PSPDR was 13.7 % (4.3 % – 29.0 %). The sensitivity of optical diagnosis for adenomas and serrated polyps were 94.5 % (83.3 % – 100 %) and 74.0 % (37.5 % – 94.1 %), respectively. No correlation could be demonstrated between the ADR and the sensitivity of optical diagnosis for adenomas (−0.20; P = 0.35) or between the PSPDR and the sensitivity of optical diagnosis for serrated polyps (−0.12; P = 0.57). Conclusions In a homogeneous FIT-positive population, no correlation between the ADR, PSPDR, and the sensitivity of optical diagnosis for adenomas and serrated polyps could be demonstrated. These exploratory results suggest that lesion detection and differentiation require different endoscopic skills. Further prospective studies are needed; until then, monitoring of both performance indicators is important to secure optimal efficacy of FIT-based colorectal cancer screening.

Tu1061 Adenoma Detection Rates Correlate With Sessile Serrated Polyp Detection Rates

2016 ◽  
Vol 83 (5) ◽  
pp. AB549
Author(s):  
Jennifer Nayor ◽  
Sergey Goryachev ◽  
Vivian S. Gainer ◽  
John R. Saltzman
Keyword(s):  
Polyp Detection ◽  
Detection Rates ◽  
Serrated Polyp ◽  
Adenoma Detection ◽  
Adenoma Detection Rates

scholarly journals Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: a prospective randomised controlled study

Gut ◽  
2019 ◽  
Vol 68 (10) ◽  
pp. 1813-1819 ◽  
Author(s):  
Pu Wang ◽  
Tyler M Berzin ◽  
Jeremy Romek Glissen Brown ◽  
Shishira Bharadwaj ◽  
Aymeric Becq ◽  
...  
Keyword(s):  
Real Time ◽  
Detection System ◽  
Cost Benefit ◽  
Controlled Study ◽  
Hyperplastic Polyps ◽  
Polyp Detection ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Adenoma Detection Rates

ObjectiveThe effect of colonoscopy on colorectal cancer mortality is limited by several factors, among them a certain miss rate, leading to limited adenoma detection rates (ADRs). We investigated the effect of an automatic polyp detection system based on deep learning on polyp detection rate and ADR.DesignIn an open, non-blinded trial, consecutive patients were prospectively randomised to undergo diagnostic colonoscopy with or without assistance of a real-time automatic polyp detection system providing a simultaneous visual notice and sound alarm on polyp detection. The primary outcome was ADR.ResultsOf 1058 patients included, 536 were randomised to standard colonoscopy, and 522 were randomised to colonoscopy with computer-aided diagnosis. The artificial intelligence (AI) system significantly increased ADR (29.1%vs20.3%, p<0.001) and the mean number of adenomas per patient (0.53vs0.31, p<0.001). This was due to a higher number of diminutive adenomas found (185vs102; p<0.001), while there was no statistical difference in larger adenomas (77vs58, p=0.075). In addition, the number of hyperplastic polyps was also significantly increased (114vs52, p<0.001).ConclusionsIn a low prevalent ADR population, an automatic polyp detection system during colonoscopy resulted in a significant increase in the number of diminutive adenomas detected, as well as an increase in the rate of hyperplastic polyps. The cost–benefit ratio of such effects has to be determined further.Trial registration numberChiCTR-DDD-17012221; Results.

scholarly journals Prevalence of ‘one and done’ in adenoma detection rates: results from the New Hampshire Colonoscopy Registry

2019 ◽  
Vol 07 (11) ◽  
pp. E1344-E1354 ◽  
Author(s):  
Stacey A. Fedewa ◽  
Joseph C. Anderson ◽  
Christina M. Robinson ◽  
Julie E. Weiss ◽  
Robert A. Smith ◽  
...  
Keyword(s):  
New Hampshire ◽  
Polyp Detection ◽  
Detection Rates ◽  
Mean Values ◽  
Quality Metric ◽  
Serrated Polyp ◽  
Performance Quality ◽  
Adenoma Detection ◽  
Adenoma Detection Rates ◽  
The One

Abstract Background and study aims Adenoma detection rate (ADR), the proportion of an endoscopist’s screening colonoscopies in which at least one adenoma is found, is an established quality metric. Several publications have suggested that a technique referred to as “one and done,” where less attention is paid to additional polyp detection following discovery of one likely adenoma, may be occurring 1 2 3. To investigate whether this practice occurs and provide additional context to the significance of ADR, we examined ADR by single and multiple adenomas in the statewide New Hampshire Colonoscopy Registry (NHCR). Patients and methods A total of 25,324 NHCR patients receiving screening colonoscopies between 2009 and 2014 by 69 endoscopists were analyzed. ADR was dichotomized into high (≥ 20 %) and low (< 20 %) based on 2006 recommended targets in place during the time of the study. ADR-plus (the average number of adenomas in colonoscopies with > 1 adenoma) was dichotomized at mean values into high (≥ 1.5) and low (< 1.5). As suggested by others, a high ADR but low ADR-plus was used to indicate the “one and done” approach. Results Among endoscopists with an ADR ≥ 20 %, only 5 (7.2 %) had low ADR-plus values and were classified as “one and done.” Results for serrated polyp detection were similar. ADR and ADR-plus decreased monotonically with increasing years since residency (P values for trend ADR = 0.02; ADR-plus = 0.003) after adjusting for patient risk factors. Conclusion “One and done” infrequently occurred among endoscopists with high ADR in a large statewide registry. The need to replace ADR with other polyp detection metrics (such as ADR-plus) to accurately ascertain performance quality is not supported by these findings.

scholarly journals The Appropriateness of Surveillance Colonoscopy Intervals after Polypectomy

2013 ◽  
Vol 27 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Eline Schreuders ◽  
Jerome Sint Nicolaas ◽  
Vincent de Jonge ◽  
Harmke van Kooten ◽  
Isaac Soo ◽  
...  
Keyword(s):  
Time Interval ◽  
Surveillance Colonoscopy ◽  
Time Intervals ◽  
Detection Rates ◽  
Median Difference ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Surveillance Interval ◽  
History Of ◽  
Adenoma Detection Rates

BACKGROUND: Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer (CRC) and unnecessary workload.OBJECTIVE: To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.METHODS: Patients with a history of adenomas or CRC who had surveillance performed between October 2008 and October 2010 were retrospectively included. Time intervals between index colonoscopy and surveillance were compared with the 2008 guideline recommendations of the American Gastroenterological Association and regarded as appropriate when the surveillance interval was within six months of the recommended time interval.RESULTS: A total of 265 patients were included (52% men; mean age 58 years). Among patients with a normal index colonoscopy (n=110), 42% received surveillance on time, 38% too early (median difference = 1.2 years too early) and 20% too late (median difference = 1.0 year too late). Among patients with nonadvanced adenomas at index (n=96), 25% underwent surveillance on time, 61% too early (median difference = 1.85) and 14% too late (median difference = 1.1). Among patients with advanced neoplasia at index (n=59), 29% underwent surveillance on time, 34% too early (median difference = 1.86) and 37% later than recommended (median difference = 1.61). No significant difference in adenoma detection rates was observed when too early surveillance versus appropriate surveillance (34% versus 33%; P=0.92) and too late surveillance versus appropriate surveillance (21% versus 33%; P=0.11) were compared.CONCLUSION: Only a minority of surveillance colonoscopies were performed according to guideline recommendations. Deviation from the guidelines did not improve the adenoma detection rate. Interventions aimed at improving adherence to surveillance guidelines are needed.

scholarly journals TOWARDS AN UNIFIED FRAMEWORK FOR VALIDATING DEEP LEARNING METHODS FOR COLORECTAL POLYPS: FIRST STEPS

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
L F Sánchez Peralta ◽  
J F Ortega Morán ◽  
Cr L Saratxaga ◽  
J B Pagador ◽  
A Picón ◽  
...  
Keyword(s):  
Deep Learning ◽  
Colorectal Polyps ◽  
Polyp Detection ◽  
Unified Framework ◽  
Endoscopic Image ◽  
Learning Techniques ◽  
Great Utility ◽  
Adenoma Detection ◽  
Definition Of ◽  
Basic Features

Abstract INTRODUCTION Deep learning techniques have significantly contributed to the field of medical imaging analysis. In case of colorectal cancer, they have shown a great utility for increasing the adenoma detection rate at colonoscopy, but a common validation methodology is still missing. In this study, we present preliminary efforts towards the definition of a validation framework. MATERIAL AND METHODS Different models based on different backbones and encoder-decoder architectures have been trained with a publicly available dataset that contains white light and NBI colonoscopy videos, with 76 different lesions from colonoscopy procedures in 48 human patients. A computer aided detection (CADe) demonstrator has been implemented to show the performance of the models. RESULTS This CADe demonstrator shows the areas detected as polyp by overlapping the predicted mask on the endoscopic image. It allows selecting the video to be used, among those from the test set. Although it only present basic features such as play, pause and moving to the next video, it easily loads the model and allows for visualization of results. The demonstrator is accompanied by a set of metrics to be used depending on the aimed task: polyp detection, localization and segmentation. CONCLUSIONS The use of this CADe demonstrator, together with a publicly available dataset and predefined metrics will allow for an easier and more fair comparison of methods. Further work is still required to validate the proposed framework.

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