Non-optical polyp-based resect and discard strategy: A prospective clinical study

Taghiakbari, Mahsa; Hammar, Celia; Frenn, Mira; Djinbachian, Roupen; Pohl, Heiko; Deslandres, Érik; Bouchard, Simon; Bouin, Mickaël; Renteln, Daniel von

doi:10.3748/wjg.v28.i19.2137

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…This might be clinically important, since polypectomy guidelines and other studies name 2–3 mm as thresholds for decision‐making between forceps and snare polypectomy 16,17 . A recent paper has also demonstrated that 3 mm might be an important cut‐off value to consider for implementation of the resect and discard approach 18,19 …”

Section: Discussionmentioning

confidence: 99%

“…16,17 A recent paper has also demonstrated that 3 mm might be an important cut-off value to consider for implementation of the resect and discard approach. 18,19 Unlike previous studies that solely used hemispherical polyps, we wanted to better mimic clinical practice by evaluating the relative accuracy of VSE for different morphology types. 15,20 For each morphology group studied, the relative accuracy was significantly higher when using VSE compared to VA (for sessile: P = 0.001; pedunculated: P = 0.002; and flat: P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

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Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: Blinded randomized controlled trial

Haumesser

Zarandi‐Nowroozi²,

Taghiakbari³

et al. 2023

Digestive Endoscopy

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Objectives The virtual scale endoscope (VSE) allows projection of a virtual scale onto colorectal polyps allowing real‐time size measurements. We studied the relative accuracy of VSE compared to visual assessment (VA) for the measuring simulated polyps of different size and morphology groups. Methods We conducted a blinded randomized controlled trial using simulated polyps within a colon model. Sixty simulated polyps were evenly distributed across four size groups (1–5, >5–9.9, 10–19.9, and ≥20 mm) and three Paris morphology groups (flat, sessile, and pedunculated). Six endoscopists performed polyp size measurements using random allocation of either VA or VSE. Results A total of 359 measurements were completed. The relative accuracy of VSE was significantly higher when compared to VA for all size groups >5 mm (P = 0.004, P < 0.001, P < 0.001). For polyps ≤5 mm, the relative accuracy of VSE compared to VA was not significantly higher (P = 0.186). The relative accuracy of VSE was significantly higher when compared to VA for all morphology groups. VSE misclassified a lower percentage of >5 mm polyps as ≤5 mm (2.9%), ≥10 mm polyps as <10 mm (5.5%), and ≥20 mm polyps as <20 mm (21.7%) compared to VA (11.2%, 24.7%, and 52.3% respectively; P = 0.008, P < 0.001, and P = 0.003). Conclusion Virtual scale endoscope had significantly higher relative accuracies for every polyp size group or morphology type aside from diminutive. VSE enables the endoscopist to better classify polyps into correct size categories at clinically relevant size thresholds of 5, 10, and 20 mm.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: Blinded randomized controlled trial

Haumesser

Zarandi‐Nowroozi²,

Taghiakbari³

et al. 2023

Digestive Endoscopy

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“…Conversely, if diminutive (<5 mm) polyps are identified during colonoscopy, many of them have benign pathology and pose little to no malignant potential. Because of this, many clinicians have proposed a pluck-and-discard strategy to avoid wasting medical resources for pathologic analysis [ 50 , 51 ]. However, this method has not yet become common practice due to the fear of missing small malignant polyps.…”

Section: Discussionmentioning

confidence: 99%

Specific Targeting and Labeling of Colonic Polyps in CPC-APC Mice with Mucin 5AC Fluorescent Antibodies: A Model for Detection of Early Colon Cancer

Turner

Cox

Liu

et al. 2023

CIMB

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Poor visualization of polyps can limit colorectal cancer screening. Fluorescent antibodies to mucin5AC (MUC5AC), a glycoprotein upregulated in adenomas and colorectal cancer, could improve screening colonoscopy polyp detection rate. Adenomatous polyposis coli flox mice with a Cdx2-Cre transgene (CPC-APC) develop colonic polyps that contain both dysplastic and malignant tissue. Mice received MUC5AC-IR800 or IRdye800 as a control IV and were sacrificed after 48 h for near-infrared imaging of their colons. A polyp-to-background ratio (PBR) was calculated for each polyp by dividing the mean fluorescence intensity of the polyp by the mean fluorescence intensity of the background tissue. The mean 25 μg PBR was 1.70 (±0.56); the mean 50 μg PBR was 2.64 (±0.97); the mean 100 μg PBR was 3.32 (±1.33); and the mean 150 μg PBR was 3.38 (±0.87). The mean PBR of the dye-only control was 2.22 (±1.02), significantly less than the 150 μg arm (p-value 0.008). The present study demonstrates the ability of fluorescent anti-MUC5AC antibodies to specifically target and label colonic polyps containing high-grade dysplasia and intramucosal adenocarcinoma in CPC-APC mice. This technology can potentially improve the detection rate and decrease the miss rate of advanced colonic neoplasia and early cancer at colonoscopy.

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Limitations of the Location-Based and Polyp-Based Resect and Discard Strategies

Yik,

Au,

Chandan

et al. 2024

Techniques and Innovations in Gastrointestinal Endoscopy

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Non-optical polyp-based resect and discard strategy: A prospective clinical study

Cited by 4 publications

References 20 publications

Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: Blinded randomized controlled trial

Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: Blinded randomized controlled trial

Specific Targeting and Labeling of Colonic Polyps in CPC-APC Mice with Mucin 5AC Fluorescent Antibodies: A Model for Detection of Early Colon Cancer

Limitations of the Location-Based and Polyp-Based Resect and Discard Strategies

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