Kaufman Daniel, Djinbachian Roupen, Taghiakbari Mahsa, Popescu Crainic Ioana, Haumesser Claire, Abou Khalil Maria, Sidani Sacha, Liu Chen Kiow Jeremy, Panzini Benoit, von Renteln Daniel
Montreal University Hospital Research Center (CRCHUM), Departement of Gastroenterology, Montreal, QC, Canada.
University of Montreal Medical School, Montreal, QC, Canada.
J Can Assoc Gastroenterol. 2023 Dec 23;7(2):149-153. doi: 10.1093/jcag/gwad057. eCollection 2024 Apr.
The virtual scale endoscope (VSE) helps endoscopists measure colorectal polyp size more accurately compared to visual assessment (VA). However, previous studies were not adequately powered to evaluate the sizing of polyps at clinically relevant size thresholds and relative accuracy for size subgroups.
We created 64 artificial polyps of varied sizes and Paris class morphology, randomly assigned 1:1 to be measured (383 total measurement datapoints with VSE and VA by 6 endoscopists blinded to true size) in a colon model. We added data from two previous trials (480 measurement datapoints). We evaluated for correct classification of polyps into size groups at 3 mm, 5 mm, 10 mm, and 20 mm size thresholds and the relative size measurement accuracy for diminutive polyps (≤5 mm), small polyps (5-9 mm), large polyps at 10-19 mm, and polyps (≥20).
VSE had significantly less size group misclassifications at the 5 mm, and 10 mm thresholds (28 percent vs. 45 percent, = 0.0159 and 26 percent vs. 44 percent, = 0.0135, respectively). For the 3 mm and 20 mm thresholds, VSE had lower misclassifications; however, this was not statistically significant (36 percent vs. 46 percent, = 0.3853 and 38 percent vs. 41 percent, = 0.2705, respectively). The relative size measurement accuracy was significantly higher for VSE compared to VA for all size subgroups (diminutive ( < 0.01), small polyps ( < 0.01), 10-19 mm ( < 0.01), and ≥20 mm ( < 0.01)).
VSE outperforms VA in categorizing polyps into size groups at the clinically relevant size thresholds of 5 mm and 10 mm. Using VSE resulted in significantly higher relative measurement accuracy for all size subgroups.
与视觉评估（VA）相比，虚拟缩放内镜（VSE）有助于内镜医师更准确地测量结直肠息肉大小。然而，先前的研究在评估临床相关大小阈值下息肉的大小以及大小亚组的相对准确性方面，样本量不足。
我们制作了64个不同大小和巴黎分类形态的人工息肉，在结肠模型中以1:1的比例随机分配进行测量（6位对真实大小不知情的内镜医师使用VSE和VA共获得383个测量数据点）。我们添加了来自之前两项试验的数据（480个测量数据点）。我们评估了息肉在3毫米、5毫米、10毫米和20毫米大小阈值下正确分类到大小组的情况，以及微小息肉（≤5毫米）、小息肉（5 - 9毫米）、10 - 19毫米的大息肉和息肉（≥20毫米）的相对大小测量准确性。
在5毫米和10毫米阈值下，VSE的大小组错误分类明显更少（分别为28%对45%，P = 0.0159；26%对44%，P = 0.0135）。对于3毫米和20毫米阈值，VSE的错误分类较低；然而，这在统计学上并不显著（分别为36%对46%，P = 0.3853；38%对41%，P = 0.2705）。对于所有大小亚组，VSE的相对大小测量准确性均显著高于VA（微小息肉（P < 0.01）、小息肉（P < 0.01）、10 - 19毫米（P < 0.01）和≥20毫米（P < 0.01））。
在5毫米和10毫米这两个临床相关大小阈值下，将息肉分类到大小组时，VSE的表现优于VA。使用VSE可使所有大小亚组的相对测量准确性显著提高。
