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

Querijn N E van Bokhorst1,2,3, Britt B S L Houwen1,2,3, Yark Hazewinkel4

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Area of Science:

  • Gastroenterology
  • Medical Imaging
  • Endoscopic Technology

Background:

  • Accurate colorectal polyp size measurement is vital for risk stratification and treatment decisions.
  • Traditional methods like visual estimation and snare sizing have limitations in accuracy and consistency.
  • A novel virtual scale (VS) function projects an adaptive scale onto polyps during endoscopy for real-time measurement.

Purpose of the Study:

  • To evaluate the virtual scale (VS) function for colorectal polyp size measurement.
  • To compare the variability and systematic differences of VS measurements against visual and snare methods.
  • To assess the impact of VS on inter-endoscopist agreement in polyp size categorization.

Main Methods:

  • A video-based study involving 120 colorectal polyps.
  • Measurements were performed by 8 expert gastroenterologists and 9 trainees using visual, snare, and VS methods.
  • Analysis focused on method-specific variance and systematic differences in polyp size measurements.

Main Results:

  • Virtual scale (VS) measurements demonstrated significantly lower variance compared to visual and snare methods for both experts and trainees (p < 0.001).
  • VS measurement led to higher agreement among endoscopists in assigning polyps to size categories.
  • The VS method reduced the maximum difference in classifying polyps as ≥10 mm compared to visual and snare methods.

Conclusions:

  • The virtual scale (VS) function significantly reduces polyp size measurement variability in endoscopy.
  • VS provides more uniform polyp sizing among endoscopists compared to visual and snare methods.
  • This improved accuracy and consistency can enhance polyp risk stratification and management decisions.