Victoria Blanes-Vidal1, Esmaeil S Nadimi2, Maria Magdalena Buijs3, Gunnar Baatrup3,4. 1. Emboddied Systems for Robotics and Learning (ESRL), The Mærsk Mc-Kinney Møller Institute, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark. vbv@mmmi.sdu.dk. 2. Emboddied Systems for Robotics and Learning (ESRL), The Mærsk Mc-Kinney Møller Institute, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark. 3. Department of Surgery, Odense University Hospital, Baagøes Alle 15, 5700, Svendborg, Denmark. 4. Faculty of Health, Department of Clinical Research, University of Southern Denmark, Winsløwsparken 19, 5000, Odense, Denmark.
Abstract
PURPOSE: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. METHODS: A fully paired study was performed (2015-2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. RESULTS: CCE overestimated size assessed by HP (by 4.3 mm; 95%CI 3.3-5.2 mm) and OC (by 2.7 mm; 95%CI 1.4-3.9 mm). Polyps were more likely to being assessed as "pedunculated" and less likely to being assessed as "flat" in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95%CI 0.66-1.00) and specificity = 0.50 (95%CI 0.32-0.68). CONCLUSIONS: If CCE is to be used as a screening test, it is essential: (1) to translate CCE polyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. TRIAL REGISTRATION: Clinicaltrials.gov No. NCT02303756.
PURPOSE: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. METHODS: A fully paired study was performed (2015-2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. RESULTS:CCE overestimated size assessed by HP (by 4.3 mm; 95%CI 3.3-5.2 mm) and OC (by 2.7 mm; 95%CI 1.4-3.9 mm). Polyps were more likely to being assessed as "pedunculated" and less likely to being assessed as "flat" in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95%CI 0.66-1.00) and specificity = 0.50 (95%CI 0.32-0.68). CONCLUSIONS: If CCE is to be used as a screening test, it is essential: (1) to translate CCEpolyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. TRIAL REGISTRATION: Clinicaltrials.gov No. NCT02303756.
Authors: C Spada; C Hassan; J P Galmiche; H Neuhaus; J M Dumonceau; S Adler; O Epstein; G Gay; M Pennazio; D K Rex; R Benamouzig; R de Franchis; M Delvaux; J Devière; R Eliakim; C Fraser; F Hagenmuller; J M Herrerias; M Keuchel; F Macrae; M Munoz-Navas; T Ponchon; E Quintero; M E Riccioni; E Rondonotti; R Marmo; J J Sung; H Tajiri; E Toth; K Triantafyllou; A Van Gossum; G Costamagna Journal: Endoscopy Date: 2012-03-02 Impact factor: 10.093
Authors: Bradley W Anderson; Thomas C Smyrk; Kari S Anderson; Douglas W Mahoney; Mary E Devens; Seth R Sweetser; John B Kisiel; David A Ahlquist Journal: Gastrointest Endosc Date: 2015-08-28 Impact factor: 9.427
Authors: Douglas K Rex; C Richard Boland; Jason A Dominitz; Francis M Giardiello; David A Johnson; Tonya Kaltenbach; Theodore R Levin; David Lieberman; Douglas J Robertson Journal: Am J Gastroenterol Date: 2017-06-06 Impact factor: 10.864
Authors: N Gopalswamy; V N Shenoy; U Choudhry; R J Markert; N Peace; M S Bhutani; C J Barde Journal: Gastrointest Endosc Date: 1997-12 Impact factor: 9.427
Authors: Else-Mariëtte B van Heijningen; Iris Lansdorp-Vogelaar; Ernst J Kuipers; Evelien Dekker; Wilco Lesterhuis; Frank Ter Borg; Juda Vecht; Vincent De Jonge; Pieter Spoelstra; Leopold Engels; Clemens J M Bolwerk; Robin Timmer; Jan H Kleibeuker; Jan J Koornstra; Marjolein van Ballegooijen; Ewout W Steyerberg Journal: Gastroenterology Date: 2013-03-07 Impact factor: 22.682
Authors: R Eliakim; K Yassin; Y Niv; Y Metzger; J Lachter; E Gal; B Sapoznikov; F Konikoff; G Leichtmann; Z Fireman; Y Kopelman; S N Adler Journal: Endoscopy Date: 2009-12-04 Impact factor: 10.093
Authors: U Deding; J Herp; A-L Havshoei; M Kobaek-Larsen; M M Buijs; E S Nadimi; G Baatrup Journal: United European Gastroenterol J Date: 2020-08 Impact factor: 4.623
Authors: Juan Francisco Ortega-Morán; Águeda Azpeitia; Luisa F Sánchez-Peralta; Luis Bote-Curiel; Blas Pagador; Virginia Cabezón; Cristina L Saratxaga; Francisco M Sánchez-Margallo Journal: BMC Cancer Date: 2021-04-26 Impact factor: 4.430
Authors: A Sahafi; Y Wang; C L M Rasmussen; P Bollen; G Baatrup; V Blanes-Vidal; J Herp; E S Nadimi Journal: Sci Rep Date: 2022-08-12 Impact factor: 4.996