Capsule endoscopy vs. colonoscopy vs. histopathology in colorectal cancer screening

matched analyses of polyp size, morphology, and location estimates

Publikation: Bidrag til tidsskriftLetterForskningpeer review

Resumé

Purpose: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. Methods: A fully paired study was performed (2015–2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. Results: CCE overestimated size assessed by HP (by 4.3 mm; 95%CI 3.3–5.2 mm) and OC (by 2.7 mm; 95%CI 1.4–3.9 mm). Polyps were more likely to being assessed as “pedunculated” and less likely to being assessed as “flat” in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95%CI 0.66–1.00) and specificity = 0.50 (95%CI 0.32–0.68). Conclusions: If CCE is to be used as a screening test, it is essential: (1) to translate CCE polyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. Trial registration: Clinicaltrials.gov No. NCT02303756.

OriginalsprogEngelsk
TidsskriftInternational Journal of Colorectal Disease
Vol/bind33
Udgave nummer9
Sider (fra-til)1309–1312
ISSN0179-1958
DOI
StatusUdgivet - sep. 2018

Fingeraftryk

Capsule Endoscopy
Early Detection of Cancer
Colorectal Neoplasms
Colon
Matched-Pair Analysis

Citer dette

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title = "Capsule endoscopy vs. colonoscopy vs. histopathology in colorectal cancer screening: matched analyses of polyp size, morphology, and location estimates",
abstract = "Purpose: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. Methods: A fully paired study was performed (2015–2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. Results: CCE overestimated size assessed by HP (by 4.3 mm; 95{\%}CI 3.3–5.2 mm) and OC (by 2.7 mm; 95{\%}CI 1.4–3.9 mm). Polyps were more likely to being assessed as “pedunculated” and less likely to being assessed as “flat” in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95{\%}CI 0.66–1.00) and specificity = 0.50 (95{\%}CI 0.32–0.68). Conclusions: If CCE is to be used as a screening test, it is essential: (1) to translate CCE polyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. Trial registration: Clinicaltrials.gov No. NCT02303756.",
keywords = "Algorithms, Capsule Endoscopy, Colonic Polyps, Colonoscopy, Colorectal Neoplasms/diagnosis, Denmark, Early Detection of Cancer, Humans",
author = "Victoria Blanes-Vidal and {S. Nadimi}, Esmaeil and Marleen Buijs and Gunnar Baatrup",
year = "2018",
month = "9",
doi = "10.1007/s00384-018-3064-0",
language = "English",
volume = "33",
pages = "1309–1312",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Heinemann",
number = "9",

}

TY - JOUR

T1 - Capsule endoscopy vs. colonoscopy vs. histopathology in colorectal cancer screening

T2 - matched analyses of polyp size, morphology, and location estimates

AU - Blanes-Vidal, Victoria

AU - S. Nadimi, Esmaeil

AU - Buijs, Marleen

AU - Baatrup, Gunnar

PY - 2018/9

Y1 - 2018/9

N2 - Purpose: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. Methods: A fully paired study was performed (2015–2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. Results: CCE overestimated size assessed by HP (by 4.3 mm; 95%CI 3.3–5.2 mm) and OC (by 2.7 mm; 95%CI 1.4–3.9 mm). Polyps were more likely to being assessed as “pedunculated” and less likely to being assessed as “flat” in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95%CI 0.66–1.00) and specificity = 0.50 (95%CI 0.32–0.68). Conclusions: If CCE is to be used as a screening test, it is essential: (1) to translate CCE polyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. Trial registration: Clinicaltrials.gov No. NCT02303756.

AB - Purpose: Colon capsule endoscopy (CCE) is considered a potential alternative to optical colonoscopy (OC) for colorectal cancer screening. However, the accuracy of CCE in polyp size and morphology estimation is unknown. Methods: A fully paired study was performed (2015–2016), where 255 participants from the Danish national screening program had CCE, OC, and histopathology (HP) of all detected polyps. We developed a new algorithm to match CCE and OC polyps, based on objective measures of similarity between polyps. We performed paired comparisons of size, morphology and location of CCE, and OC- and HP-matched polyps. We used cross-validation to develop a model able to predict HP polyp size, based on CCE. Results: CCE overestimated size assessed by HP (by 4.3 mm; 95%CI 3.3–5.2 mm) and OC (by 2.7 mm; 95%CI 1.4–3.9 mm). Polyps were more likely to being assessed as “pedunculated” and less likely to being assessed as “flat” in CCE, compared to OC (p < 0.0001). Our model could predict HP polyp size ≥ 6 mm, solely using CCE-assessed size, location, and morphology as model inputs, with a sensitivity = 0.93 (95%CI 0.66–1.00) and specificity = 0.50 (95%CI 0.32–0.68). Conclusions: If CCE is to be used as a screening test, it is essential: (1) to translate CCE polyp estimations into histopathologic polyp sizes and (2) to consider that, compared to OC, CCE has a higher tendency to assess polyps as pedunculated and a lower tendency to assess them as flat. Trial registration: Clinicaltrials.gov No. NCT02303756.

KW - Algorithms

KW - Capsule Endoscopy

KW - Colonic Polyps

KW - Colonoscopy

KW - Colorectal Neoplasms/diagnosis

KW - Denmark

KW - Early Detection of Cancer

KW - Humans

U2 - 10.1007/s00384-018-3064-0

DO - 10.1007/s00384-018-3064-0

M3 - Letter

VL - 33

SP - 1309

EP - 1312

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 9

ER -