Comparing size measurements of simulated colorectal polyp size and morphology groups when using a virtual scale endoscope or visual size estimation: Blinded randomized controlled trial

• Published in: Digestive endoscopy Vol. 35; no. 5; pp. 638 - 644
• Main Authors: Haumesser, Claire, Zarandi‐Nowroozi, Melissa, Taghiakbari, Mahsa, Djinbachian, Roupen, Abou Khalil, Maria, Sidani, Sacha, Liu Chen Kiow, Jeremy, Panzini, Benoit, Popescu Crainic, Ioana, Renteln, Daniel
• Format: Journal Article
• Language: English
• Published: Australia 01.07.2023
• Subjects: colonic polyp; Colonic Polyps - diagnosis; Colonic Polyps - surgery; Colonoscopy; colorectal cancer; Colorectal Neoplasms - surgery; endoscope; Endoscopes; Humans; polyp size estimation; colorectal cancer; polyp size estimation; colonoscopy; endoscope; colonic polyp
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/den.14498

Objectives The virtual scale endoscope (VSE) allows projection of a virtual scale onto colorectal polyps allowing real‐time size measurements. We studied the relative accuracy of VSE compared to visual assessment (VA) for the measuring simulated polyps of different size and morphology groups. Methods We conducted a blinded randomized controlled trial using simulated polyps within a colon model. Sixty simulated polyps were evenly distributed across four size groups (1–5, >5–9.9, 10–19.9, and ≥20 mm) and three Paris morphology groups (flat, sessile, and pedunculated). Six endoscopists performed polyp size measurements using random allocation of either VA or VSE. Results A total of 359 measurements were completed. The relative accuracy of VSE was significantly higher when compared to VA for all size groups >5 mm (P = 0.004, P < 0.001, P < 0.001). For polyps ≤5 mm, the relative accuracy of VSE compared to VA was not significantly higher (P = 0.186). The relative accuracy of VSE was significantly higher when compared to VA for all morphology groups. VSE misclassified a lower percentage of >5 mm polyps as ≤5 mm (2.9%), ≥10 mm polyps as <10 mm (5.5%), and ≥20 mm polyps as <20 mm (21.7%) compared to VA (11.2%, 24.7%, and 52.3% respectively; P = 0.008, P < 0.001, and P = 0.003). Conclusion Virtual scale endoscope had significantly higher relative accuracies for every polyp size group or morphology type aside from diminutive. VSE enables the endoscopist to better classify polyps into correct size categories at clinically relevant size thresholds of 5, 10, and 20 mm.