Usefulness of a Colonoscopy Cap with an External Grid for the Measurement of Small-Sized Colorectal Polyps: A Prospective Randomized Trial

Han, Sang Do; Kim, Hyunil; Kim, Jin-Woo; Kim, Hyunsoo; Kim, Su‐Young; Park, Hong-Jun

doi:10.3390/jcm10112365

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…Median measurement duration for flat and non-flat polyps was comparable (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) vs. 18 [IQR 10-33] seconds). Five endoscopists who used the VS in clinical practice graded VS endoscope userfriendliness an average at five on a ten points scale (with one representing the worst user-friendliness and ten representing the best user-friendliness).…”

Section: Resultsmentioning

confidence: 99%

Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences

van Bokhorst,

Houwen,

Hazewinkel

et al. 2024

Endoscopy

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Background Accurate polyp size measurement is important for polyp risk stratification and decision-making regarding polypectomy and surveillance. Recently, a virtual scale (VS) function has been developed that allows polyp size measurement through projection of an adaptive VS onto colorectal polyps during real-time endoscopy. We aimed to evaluate the VS in terms of variability and systematic differences. Methods We conducted a video-based study with 120 colorectal polyps, measured by eight dedicated colorectal gastroenterologists (experts) and nine gastroenterology residents following endoscopy training (trainees). Three endoscopic measurement methods were compared: (1) visual, (2) snare and (3) VS measurement. We evaluated the method-specific variance (as measure of variability) in polyp size measurements and systematic differences between these methods. Results Variance in polyp size measurements was significantly lower for VS measurements compared to visual and snare measurements for both experts (0.52 vs. 1.59 and 1.96, p<0.001) and trainees (0.59 vs. 2.21 and 2.53, p<0.001). VS measurement resulted in a higher percentage of polyps assigned to the same size category by all endoscopists compared to visual and snare measurements (experts: 69% vs. 55% and 59%; trainees: 67% vs. 51% and 47%) and reduced the maximum difference between individual endoscopists regarding the percentage of polyps assigned to the <u>></u>10 mm size category (experts: 1.7% vs. 10.0% and 5.0%; trainees: 2.5% vs. 6.7% and 11.7%). Systematic differences between methods were <0.5 mm. <b>Conclusions</b> Use of the VS leads to lower polyp size measurement variability and more uniform polyp sizing by individual endoscopists compared to visual and snare measurements.

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Section: Resultsmentioning

confidence: 99%

Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences

van Bokhorst,

Houwen,

Hazewinkel

et al. 2024

Endoscopy

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“…Various add-on tools, such as endoscopic rulers, open forceps, and graduated needles, have been used to improve accuracy in lesion size measurement; however, an add-on colonoscopy cap is the most accessible and affordable option thus far. [19][20][21][22] In a prospective randomized trial, Han et al 23 placed a transparent grid with 1-mm-spaced grid lines inside a colonoscopic cap upon encountering a polyp to measure its size (Fig. 4).…”

Section: A a B Bmentioning

confidence: 99%

“…(F) Polyp size is also measured with forceps. Adapted from Han et al J Clin Med 2021;10:2365, according to the Creative Commons license 23.…”

mentioning

confidence: 99%

The role of cap-assisted endoscopy and its future implications

Kim,

Lee

2024

Clin Endosc

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Cap-assisted endoscopy refers to a procedure in which a short tube made of a polymer (mostly transparent) is attached to the distal tip of the endoscope to enhance its diagnostic and therapeutic capabilities. It is reported to be particularly useful in: (1) minimizing blind spots during screening colonoscopy, (2) providing a constant distance from a lesion for clear visualization during magnifying endoscopy, (3) accurately assessing the size of various gastrointestinal lesions, (4) preventing mucosal injury during foreign body removal, (5) securing adequate workspace in the submucosal space during endoscopic submucosal dissection or third space endoscopy, (6) providing an optimal approach angle to a target, and (7) suctioning mucosal and submucosal tissue with negative pressure for resection or approximation. Here, we review various applications of attachable caps in diagnostic and therapeutic endoscopy and their future implications.

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“…To tackle this problem, the use of a graduated endoscopic device has been widely proposed, such as a ruler snare [ 13 ], disposal graduated biopsy forceps [ 14 ] or a colonoscopy cap [ 15 ]. The limitations of being time-consuming and subjective aside, using a device might be only applicable up to a certain size [ 15 ], and the performance highly depends on whether the device can appropriately align with the polyp.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic measurement of the size of gastrointestinal polyps using an electromagnetic tracking system and computer vision-based algorithm

Safavian,

Toh,

Pani

et al. 2023

Int J CARS

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Purpose Polyp size is an important factor that may influence diagnosis and clinical management decision, but estimation by visual inspection during endoscopy is often difficult and subject to error. The purpose of this study is to develop a quantitative approach that enables an accurate and objective measurement of polyp size and to study the feasibility of the method. Methods We attempted to estimate polyp size and location relative to the gastro-oesophageal junction by integrating data from an electromagnetic tracking sensor and endoscopic images. This method is based on estimation of the three-dimensional coordinates of the borders of the polyp by combining the endoscope camera position and the corresponding points along the polyp border in endoscopic images using a computer vision-based algorithm. We evaluated the proposed method using a simulated upper gastrointestinal endoscopy model. Results The difference between the mean of ten measurements of one artificial polyp and its actual size (10 mm in diameter) was 0.86 mm. Similarly, the difference between the mean of ten measurements of the polyp distance from the gastroesophageal junction and its actual distance (~ 22 cm) was 1.28 mm. Our results show that the changes in camera positions in which the images were taken and the quality of the polyp segmentation have the most impact on the accuracy of polyp size estimation. Conclusion This study demonstrated an innovative approach to endoscopic measurements using motion tracking technologies and computer vision and demonstrated its accuracy in determining the size and location of the polyp. The observed magnitude of error is clinically acceptable, and the measurements are available immediately after the images captured. To enhance accuracy, it is recommended to avoid identical images and instead utilise control wheels on the endoscope for capturing different views. Future work should further evaluate this innovative method during clinical endoscopic procedures.

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Usefulness of a Colonoscopy Cap with an External Grid for the Measurement of Small-Sized Colorectal Polyps: A Prospective Randomized Trial

Cited by 4 publications

References 25 publications

Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences

Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences

The role of cap-assisted endoscopy and its future implications

Endoscopic measurement of the size of gastrointestinal polyps using an electromagnetic tracking system and computer vision-based algorithm

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