I-scan optical enhancement for the in vivo prediction of diminutive colorectal polyp histology: Results from a prospective three-phased multicentre trial

Klenske E, Zopf S, Neufert C, Naegel A, Gschossmann J, Muehldorfer S, Pfeifer L, Fischer S, Vitali F, Iacucci M, Ghosh S, Rath MG, Klare P, Tontini GE, Neurath M, Rath T, Siebler J (2018)

Publication Type: Journal article

Publication year: 2018

Journal

PLoS ONE Public Library of Science

Book Volume: 13

Journal Issue: 5

DOI: 10.1371/journal.pone.0197520

Abstract

BACKGROUND AND AIMS: Dye-less chromoendoscopy is an emerging technology for colorectal polyp characterization. Herein, we investigated whether the newly introduced I-scan optical enhancement (OE) can accurately predict polyp histology in vivo in real-time. METHODS: In this prospective three-phased study, 84 patients with 230 diminutive colorectal polyps were included. During the first two study phases, five endoscopists assessed whether analysis of polyp colour, surface and vascular pattern under i-scan OE can differentiate in vivo between adenomatous and hyperplastic polyps. Finally, junior and experienced endoscopists (JE, EE, each n = 4) not involved in the prior study phases made a post hoc diagnosis of polyp histology using a static i-scan OE image database. Histopathology was used as a gold-standard in all study phases. RESULTS: The overall accuracy of i-scan OE for histology prediction was 90% with a sensitivity, specificity, positive (PPV) and negative prediction value (NPV) of 91%, 90%, 86% and 94%, respectively. In high confidence predictions, the diagnostic accuracy increased to 93% with sensitivity, specificity, PPV and NPV of 94%, 91%, 89% and 96%. Colonoscopy surveillance intervals were predicted correctly in ≥ 90% of patients. In the post hoc analysis EE predicted polyp histology under i-scan OE with an overall accuracy of 91%. After a single training session, JE achieved a comparable diagnostic performance for predicting polyp histology with i-scan OE. CONCLUSION: The histology of diminutive colorectal polyps can be accurately predicted with i-scan OE in vivo in real-time. Furthermore, polyp differentiation with i-scan OE appears to require only a short learning curve.

Authors with CRIS profile

Steffen Zopf Medizinische Fakultät Clemens Neufert Medizinische Fakultät Lukas Pfeifer Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Sören Fischer Department of Transfusion Medicine and Haemostaseology Francesco Vitali Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Markus Neurath Lehrstuhl für Innere Medizin I Jürgen Siebler Professur für Hepatologie

Involved external institutions

Klinikum Bayreuth DE Germany (DE) Ruprecht-Karls-Universität Heidelberg DE Germany (DE) University of Birmingham GB United Kingdom (GB) Klinikum Forchheim DE Germany (DE) IRCCS Policlinico San Donato IT Italy (IT) Technische Universität München (TUM) DE Germany (DE)

How to cite

APA:

Klenske, E., Zopf, S., Neufert, C., Naegel, A., Gschossmann, J., Muehldorfer, S.,... Siebler, J. (2018). I-scan optical enhancement for the in vivo prediction of diminutive colorectal polyp histology: Results from a prospective three-phased multicentre trial. PLoS ONE, 13(5). https://dx.doi.org/10.1371/journal.pone.0197520

MLA:

Klenske, Entcho, et al. "I-scan optical enhancement for the in vivo prediction of diminutive colorectal polyp histology: Results from a prospective three-phased multicentre trial." PLoS ONE 13.5 (2018).

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