High-definition endoscopy with digital chromoendoscopy for histologic prediction of distal colorectal polyps

Language
en
Document Type
Article
Issue Date
2016-07-25
Issue Year
2015
Authors
Rath, Timo
Tontini, Gian E.
Nägel, Andreas
Vieth, Michael
Zopf, Steffen
Günther, Claudia
Hoffman, Arthur
Neurath, Markus F.
Neumann, Helmut
Editor
Abstract

Background

Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. Methods

In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital chromoendoscopy and the accuracy of predicting histology with digital chromoendoscopy was assessed. Results

The overall accuracy of digital chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital chromoendoscopy were correctly predicted with >90 % accuracy. Conclusions

High-definition endoscopy in combination with digital chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps.

Journal Title
BMC Gastroenterology
Volume
15
Issue
145-152
Citation

BMC Gastroenterology 15(2015):S.145-152. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619024/

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