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Optical Diagnosis of Colorectal Polyps: Recent Developments

  • Colon (J Anderson, Section Editor)
  • Published:
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Abstract

Purpose of review

Optical diagnosis of diminutive colorectal polyps has been recently proposed as an alternative to histopathologic diagnosis. Recent developments in imaging techniques, new classification systems, and the use of artificial intelligence have allowed for increased viability of optical diagnosis. This review provides an up-to-date overview of optical diagnosis recommendations, classifications, outcomes, and recent developments.

Recent findings

There are currently seven major classification systems and three major society recommendations for quality benchmarks for optical diagnosis of diminutive polyps. The NICE classification has been extensively studied and meets quality benchmarks for most imaging techniques but does not allow for the diagnosis of sessile serrated polyps (SSPs). The SIMPLE classification has met quality benchmarks for NBI and i-Scan and allows for the diagnosis of SSPs. Other classification systems need to be further studied to validate effectiveness. Computer-assisted diagnosis of colorectal polyps is a very promising recent development with first studies showing that society-recommended quality benchmarks for real-time colonoscopies on patients are being met. Limitations include a non-negligible percentage of failure to diagnose, low specificity, and low number of real-time diagnostic studies. More research needs to be performed to further understand the value of artificial intelligence for optical polyp diagnosis.

Summary

Optical diagnosis of diminutive colorectal polyps is currently a viable strategy for experienced endoscopists using validated classifications and imaging-enhanced endoscopy. Artificial intelligence–based diagnosis could make optical diagnosis widely applicable but is currently in its early developmental stage.

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Abbreviations

AI:

Artificial intelligence

ASGE:

American Society for Gastrointestinal Endoscopy

CAD:

Computer-aided diagnostic

BLI:

Blue light imaging

ESGE:

European Society of Gastrointestinal Endoscopy

FICE:

Fujinon intelligent color enhancement

FIT:

Fecal immunochemical test

NBI:

Narrow-band imaging

NIHCE:

National Institute for Health and Care Excellence

NICE classification:

NBI International Colorectal Endoscopic Classification

NPV:

Negative predictive value

OE:

Optivista optical enhancement

SSP:

Sessile serrated polyp

SSA:

Sessile serrated adenoma

WASP:

Workgroup on serrAted polypS and Polyposis

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Faculty of Medicine, University of Montreal, Montreal, Canada

    Roupen Djinbachian B.Sc, MD & Anne-Julie Dubé DEC, MD

  2. Montreal University Hospital Research Center (CRCHUM), Montreal, Canada

    Roupen Djinbachian B.Sc, MD, Anne-Julie Dubé DEC, MD & Daniel von Renteln MD

  3. Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal, Canada

    Daniel von Renteln MD

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  1. Roupen Djinbachian B.Sc, MD
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Roupen Djinbachian: literature review, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.Anne-Julie Dubé: analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.Daniel von Renteln: study concept and design, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.

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Correspondence to Daniel von Renteln MD.

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Roupen Djinbachian declares that he has no conflict of interest. Anne-Julie Dubé declares that she has no conflict of interest. Daniel von Renteln is supported by a “Fonds de Recherche du Québec Santé” career development award and has received consultation fees from Boston Scientific and research funding from ERBE, Ventage and Pentax.

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Djinbachian, R., Dubé, AJ. & von Renteln, D. Optical Diagnosis of Colorectal Polyps: Recent Developments. Curr Treat Options Gastro 17, 99–114 (2019). https://doi.org/10.1007/s11938-019-00220-x

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