Accuracy for Optical Diagnosis of Small Colorectal Polyps in Nonacademic Settings
Abstract
Background & aims When small colorectal lesions are accurately characterized, adenomas can be removed and discarded without formal histopathology analysis. Previous studies in an academic setting showed that many lesions can be managed accurately on the basis of their endoscopic image (optical diagnosis). We performed a prospective study to assess the accuracy of optical diagnosis of small colorectal polyps in a nonacademic setting (the DISCOUNT trial) by using high-resolution endoscopy (HRE) and narrow-band imaging (NBI). Methods During colonoscopy, 1 of 3 nonacademic endoscopists characterized small lesions and declared whether this was done with low or high confidence. In cases of high confidence, the endoscopists decided whether lesions should be removed and discarded or whether they could be left in situ. A surveillance interval was then recommended on-site. Results Of 215 patients in the study, 108 were found to have 281 small lesions. Of these lesions, 231 were characterized with high confidence by using HRE or NBI; the level of corresponding sensitivity was 77.0% (95% confidence interval, 68.4-83.8), and specificity was 78.8% (95% confidence interval, 70.6-85.2). Of these lesions, 164 were assigned for removal, and 67 were assigned to remain in situ, including 9 adenomas. In 54 patients, a surveillance interval could be recommended on-site that was in line with Dutch guidelines for 44 patients. Conclusions Even though many lesions were characterized by HRE or NBI with…
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Colorectal polyps were histologically characterized as adenoma, hyperplastic polyp, or sessile serrated lesion by expert pathologists according to the revised Vienna and World Health Organization classification.
“Colorectal polyps were histologically characterized as adenoma (AD), HP, or sessile serrated lesion (SSL) by expert pathologists according to the revised Vienna and World Health Organization classification.3,4”
From Structured Integration of an Artificial Intelligence-Based System for the Optical Diagnosis of Colorectal Polyps (2026) · cites this paper as [3]
The limited clinical uptake of diagnose-and-leave and resect-and-discard strategies is due to their suboptimal accuracy.
“However, the limited clinical uptake of these strategies is due to their suboptimal accuracy.3-6”
From Structured Integration of an Artificial Intelligence-Based System for the Optical Diagnosis of Colorectal Polyps (2026) · cites this paper as [3]
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- Authors
- Kuiper, T., Marsman, W. A., Jansen, J. M., van Soest, E. J., Haan, Y. C. L., Bakker, G. J., Fockens, P., & Dekker, E.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- OLVG (NL)
- Corresponding author
- Dekker, Evelien
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 10
- Issue
- 9
- Pages
- 1016-1020
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2076464948
- Cited by
- 110
- References
- 1
- Citations by year
- 2025: 4 · 2024: 8 · 2023: 2 · 2022: 6 · 2021: 8 · 2020: 11 · 2019: 11 · 2018: 7 · 2017: 6 · 2016: 4 · 2015: 17 · 2014: 13 · 2013: 13
- FWCI
- 6.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
- Keywords
- small colorectal polyps, optical diagnostics, narrow-band imaging, high-resolution endoscopy, adenoma classification, surveillance interval
- MeSH terms
- Adult, Aged, Aged, 80 and over, Colonoscopy, Female, Humans, Male, Middle Aged, Polyps, Prospective Studies, Sensitivity and Specificity, Colorectal Neoplasms
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