Helmut Neumann1, Helmut Neumann Sen2, Michael Vieth3, Raf Bisschops4, Florian Thieringer1, Khan F Rahman1, Thomas Gamstätter1, Gian Eugenio Tontini5, Peter R Galle1. 1. First Medical Department, Interdisciplinary Endoscopy, University Medical Center Mainz, Mainz, Germany. 2. Internistische Schwerpunktpraxis Bad Salzuflen, Germany. 3. Institute of Pathology, Klinikum Bayreuth, Germany. 4. Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium. 5. Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
OBJECTIVES: A negative predictive value of more than 90% is proposed by the American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) statement for a new technology in order to leave distal diminutive colorectal polyps in place without resection. To our knowledge, no prior prospective study has yet evaluated the feasibility of the most recently introduced blue light imaging (BLI) system for real-time endoscopic prediction of polyp histology for the specific endpoint of leaving hyperplastic polyps in place. AIMS: Prospective assessment of real-time prediction of colorectal polyps by using BLI. MATERIAL AND METHODS: In total, 177 consecutive patients undergoing screening or surveillance colonoscopy were included. Colorectal polyps were evaluated in real-time by using high-definition endoscopy and the BLI technology without optical magnification. Before resection, the endoscopist described each polyp according to size, shape and surface characteristics (pit and vascular pattern, colour and depression), and histology was predicted with a level of confidence (high or low). RESULTS: Histology was predicted with high confidence in 92.5% of polyps. Sensitivity of BLI for prediction of adenomatous histology was 92.68%, with a specificity and accuracy of 94.87 and 93.75%, respectively. Following the recommendation of the PIVI statement, positive and negative predictive values were calculated with values of 95 and 92.5%, respectively. Prediction of surveillance based on both US and European guidelines was correctly predicted in 91% of patients. CONCLUSION: The most recently introduced BLI technology is accurate enough to leave distal colorectal polyps in place without resection. BLI also allowed for assignment of postpolypectomy surveillance intervals. This approach therefore has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps.
OBJECTIVES: A negative predictive value of more than 90% is proposed by the American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) statement for a new technology in order to leave distal diminutive colorectal polyps in place without resection. To our knowledge, no prior prospective study has yet evaluated the feasibility of the most recently introduced blue light imaging (BLI) system for real-time endoscopic prediction of polyp histology for the specific endpoint of leaving hyperplastic polyps in place. AIMS: Prospective assessment of real-time prediction of colorectal polyps by using BLI. MATERIAL AND METHODS: In total, 177 consecutive patients undergoing screening or surveillance colonoscopy were included. Colorectal polyps were evaluated in real-time by using high-definition endoscopy and the BLI technology without optical magnification. Before resection, the endoscopist described each polyp according to size, shape and surface characteristics (pit and vascular pattern, colour and depression), and histology was predicted with a level of confidence (high or low). RESULTS: Histology was predicted with high confidence in 92.5% of polyps. Sensitivity of BLI for prediction of adenomatous histology was 92.68%, with a specificity and accuracy of 94.87 and 93.75%, respectively. Following the recommendation of the PIVI statement, positive and negative predictive values were calculated with values of 95 and 92.5%, respectively. Prediction of surveillance based on both US and European guidelines was correctly predicted in 91% of patients. CONCLUSION: The most recently introduced BLI technology is accurate enough to leave distal colorectal polyps in place without resection. BLI also allowed for assignment of postpolypectomy surveillance intervals. This approach therefore has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps.
Authors: Arthur Hoffman; Linn Loth; Johannes Wilhelm Rey; Fareed Rahman; Martin Goetz; Torsten Hansen; Achim Tresch; Theresa Niederberger; Peter Robert Galle; Ralf Kiesslich Journal: Dig Liver Dis Date: 2014-08-20 Impact factor: 4.088
Authors: R Valori; J-F Rey; W S Atkin; M Bretthauer; C Senore; G Hoff; E J Kuipers; L Altenhofen; R Lambert; G Minoli Journal: Endoscopy Date: 2012-09-25 Impact factor: 10.093
Authors: Tonya Kaltenbach; Amit Rastogi; Robert V Rouse; Kenneth R McQuaid; Tohru Sato; Ajay Bansal; Jon C Kosek; Roy Soetikno Journal: Gut Date: 2014-11-11 Impact factor: 23.059
Authors: Peter Klare; Bernhard Haller; Sandra Wormbt; Ellen Nötzel; Dirk Hartmann; Jörg Albert; Johannes Hausmann; Henrik Einwächter; Andreas Weber; Mohamed Abdelhafez; Roland M Schmid; Stefan von Delius Journal: Endoscopy Date: 2016-07-22 Impact factor: 10.093
Authors: Heinz Albrecht; Andreas Nägel; Hüseyin Tasdelen; Timo Rath; Martin Grauer; Michael Vieth; Markus F Neurath; Helmut Neumann Journal: J Clin Gastroenterol Date: 2016 Nov/Dec Impact factor: 3.062
Authors: Britt B S L Houwen; Jasper L A Vleugels; Maria Pellisé; Liseth Rivero-Sánchez; Francesc Balaguer; Raf Bisschops; Sabine Tejpar; Alessandro Repici; D Ramsoekh; M A J M Jacobs; Ramon-Michel Schreuder; Michal F Kamiński; Maria Rupińska; Pradeep Bhandari; M G H van Oijen; L Koens; Barbara A J Bastiaansen; K M A J Tytgat; Paul Fockens; Evelien Dekker; Yark Hazewinkel Journal: Endosc Int Open Date: 2022-01-14