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Endoscopic versus histological characterisation of polyps during screening colonoscopy

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Endoscopic versus histological characterisation of polyps during screening colonoscopy. / Schachschal, Guido; Mayr, Michael; Treszl, Andras; Balzer, Klaus; Wegscheider, Karl; Aschenbeck, Jens; Aminalai, Alireza; Drossel, Rolf; Schröder, Andreas; Scheel, Mathias; Bothe, Carl-Hermann; Bruhn, Jens-Peter; Burmeister, Wolfgang; Stange, Gabriela; Bähr, Christina; Kießlich, Ralf; Rösch, Thomas.

in: GUT, Jahrgang 63, Nr. 3, 01.03.2014, S. 458-65.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schachschal, G, Mayr, M, Treszl, A, Balzer, K, Wegscheider, K, Aschenbeck, J, Aminalai, A, Drossel, R, Schröder, A, Scheel, M, Bothe, C-H, Bruhn, J-P, Burmeister, W, Stange, G, Bähr, C, Kießlich, R & Rösch, T 2014, 'Endoscopic versus histological characterisation of polyps during screening colonoscopy', GUT, Jg. 63, Nr. 3, S. 458-65. https://doi.org/10.1136/gutjnl-2013-304562

APA

Schachschal, G., Mayr, M., Treszl, A., Balzer, K., Wegscheider, K., Aschenbeck, J., Aminalai, A., Drossel, R., Schröder, A., Scheel, M., Bothe, C-H., Bruhn, J-P., Burmeister, W., Stange, G., Bähr, C., Kießlich, R., & Rösch, T. (2014). Endoscopic versus histological characterisation of polyps during screening colonoscopy. GUT, 63(3), 458-65. https://doi.org/10.1136/gutjnl-2013-304562

Vancouver

Schachschal G, Mayr M, Treszl A, Balzer K, Wegscheider K, Aschenbeck J et al. Endoscopic versus histological characterisation of polyps during screening colonoscopy. GUT. 2014 Mär 1;63(3):458-65. https://doi.org/10.1136/gutjnl-2013-304562

Bibtex

@article{d9a6018971e54470aa017ba1bf686cc6,
title = "Endoscopic versus histological characterisation of polyps during screening colonoscopy",
abstract = "BACKGROUND: As screening colonoscopy becomes more widespread, the costs for histopathological assessment of resected polyps are rising correspondingly. Reference centres have published highly accurate results for endoscopic polyp classification. Therefore, it has been proposed that, for smaller polyps, the differential diagnosis that guides follow-up recommendations could be based on endoscopy alone.OBJECTIVE: The aim was to prospectively assess whether the high accuracy for endoscopic polyp diagnosis as reported by reference centres can be reproduced in routine screening colonoscopy.DESIGN: Ten experienced private practice endoscopists had initial training in pit patterns. Then they assessed all polyps detected during 1069 screening colonoscopies. Patients (46% men; mean age 63 years) were randomly assigned to colonoscopy with conventional or latest generation HDTV instruments. The main outcome measure was diagnostic accuracy of in vivo polyp assessment (adenomatous vs hyperplastic). Secondary outcome measures were differences between endoscopes and reliability of image-based follow-up recommendations; a blinded post hoc analysis of polyp photographs was also performed.RESULTS: 675 polyps were assessed (461 adenomatous, 214 hyperplastic). Accuracy, sensitivity and specificity of in vivo diagnoses were 76.6%, 78.1% and 73.4%; size of adenomas and endoscope withdrawal time significantly influenced accuracy. Image-based recommendations for post-polypectomy surveillance were correct in only 69.5% of cases. Post hoc analysis of polyp photographs did not improve accuracy.CONCLUSIONS: In everyday practice, endoscopic classification of polyp type is not accurate enough to abandon histopathological assessment and use of latest generation colonoscopes does not improve this. Image-based surveillance recommendations after polypectomy would consequently not meet guideline requirements.TRIALREGNO: NCT01297712.",
keywords = "Adenomatous Polyps, Aged, Colonic Neoplasms, Colonic Polyps, Colonoscopes, Colonoscopy, Diagnosis, Differential, Early Detection of Cancer, Female, Humans, Logistic Models, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Single-Blind Method",
author = "Guido Schachschal and Michael Mayr and Andras Treszl and Klaus Balzer and Karl Wegscheider and Jens Aschenbeck and Alireza Aminalai and Rolf Drossel and Andreas Schr{\"o}der and Mathias Scheel and Carl-Hermann Bothe and Jens-Peter Bruhn and Wolfgang Burmeister and Gabriela Stange and Christina B{\"a}hr and Ralf Kie{\ss}lich and Thomas R{\"o}sch",
year = "2014",
month = mar,
day = "1",
doi = "10.1136/gutjnl-2013-304562",
language = "English",
volume = "63",
pages = "458--65",
journal = "GUT",
issn = "0017-5749",
publisher = "BMJ PUBLISHING GROUP",
number = "3",

}

RIS

TY - JOUR

T1 - Endoscopic versus histological characterisation of polyps during screening colonoscopy

AU - Schachschal, Guido

AU - Mayr, Michael

AU - Treszl, Andras

AU - Balzer, Klaus

AU - Wegscheider, Karl

AU - Aschenbeck, Jens

AU - Aminalai, Alireza

AU - Drossel, Rolf

AU - Schröder, Andreas

AU - Scheel, Mathias

AU - Bothe, Carl-Hermann

AU - Bruhn, Jens-Peter

AU - Burmeister, Wolfgang

AU - Stange, Gabriela

AU - Bähr, Christina

AU - Kießlich, Ralf

AU - Rösch, Thomas

PY - 2014/3/1

Y1 - 2014/3/1

N2 - BACKGROUND: As screening colonoscopy becomes more widespread, the costs for histopathological assessment of resected polyps are rising correspondingly. Reference centres have published highly accurate results for endoscopic polyp classification. Therefore, it has been proposed that, for smaller polyps, the differential diagnosis that guides follow-up recommendations could be based on endoscopy alone.OBJECTIVE: The aim was to prospectively assess whether the high accuracy for endoscopic polyp diagnosis as reported by reference centres can be reproduced in routine screening colonoscopy.DESIGN: Ten experienced private practice endoscopists had initial training in pit patterns. Then they assessed all polyps detected during 1069 screening colonoscopies. Patients (46% men; mean age 63 years) were randomly assigned to colonoscopy with conventional or latest generation HDTV instruments. The main outcome measure was diagnostic accuracy of in vivo polyp assessment (adenomatous vs hyperplastic). Secondary outcome measures were differences between endoscopes and reliability of image-based follow-up recommendations; a blinded post hoc analysis of polyp photographs was also performed.RESULTS: 675 polyps were assessed (461 adenomatous, 214 hyperplastic). Accuracy, sensitivity and specificity of in vivo diagnoses were 76.6%, 78.1% and 73.4%; size of adenomas and endoscope withdrawal time significantly influenced accuracy. Image-based recommendations for post-polypectomy surveillance were correct in only 69.5% of cases. Post hoc analysis of polyp photographs did not improve accuracy.CONCLUSIONS: In everyday practice, endoscopic classification of polyp type is not accurate enough to abandon histopathological assessment and use of latest generation colonoscopes does not improve this. Image-based surveillance recommendations after polypectomy would consequently not meet guideline requirements.TRIALREGNO: NCT01297712.

AB - BACKGROUND: As screening colonoscopy becomes more widespread, the costs for histopathological assessment of resected polyps are rising correspondingly. Reference centres have published highly accurate results for endoscopic polyp classification. Therefore, it has been proposed that, for smaller polyps, the differential diagnosis that guides follow-up recommendations could be based on endoscopy alone.OBJECTIVE: The aim was to prospectively assess whether the high accuracy for endoscopic polyp diagnosis as reported by reference centres can be reproduced in routine screening colonoscopy.DESIGN: Ten experienced private practice endoscopists had initial training in pit patterns. Then they assessed all polyps detected during 1069 screening colonoscopies. Patients (46% men; mean age 63 years) were randomly assigned to colonoscopy with conventional or latest generation HDTV instruments. The main outcome measure was diagnostic accuracy of in vivo polyp assessment (adenomatous vs hyperplastic). Secondary outcome measures were differences between endoscopes and reliability of image-based follow-up recommendations; a blinded post hoc analysis of polyp photographs was also performed.RESULTS: 675 polyps were assessed (461 adenomatous, 214 hyperplastic). Accuracy, sensitivity and specificity of in vivo diagnoses were 76.6%, 78.1% and 73.4%; size of adenomas and endoscope withdrawal time significantly influenced accuracy. Image-based recommendations for post-polypectomy surveillance were correct in only 69.5% of cases. Post hoc analysis of polyp photographs did not improve accuracy.CONCLUSIONS: In everyday practice, endoscopic classification of polyp type is not accurate enough to abandon histopathological assessment and use of latest generation colonoscopes does not improve this. Image-based surveillance recommendations after polypectomy would consequently not meet guideline requirements.TRIALREGNO: NCT01297712.

KW - Adenomatous Polyps

KW - Aged

KW - Colonic Neoplasms

KW - Colonic Polyps

KW - Colonoscopes

KW - Colonoscopy

KW - Diagnosis, Differential

KW - Early Detection of Cancer

KW - Female

KW - Humans

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Sensitivity and Specificity

KW - Single-Blind Method

U2 - 10.1136/gutjnl-2013-304562

DO - 10.1136/gutjnl-2013-304562

M3 - SCORING: Journal article

C2 - 23812324

VL - 63

SP - 458

EP - 465

JO - GUT

JF - GUT

SN - 0017-5749

IS - 3

ER -