Endoscopic mucosal resection defect inspection for predicting recurrences: International image-based survey

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Colorectal cancer screening

Background:

• Endoscopic mucosal resection (EMR) is a standard treatment for non-pedunculated colorectal polyps.
• High recurrence rates after EMR necessitate improved detection and management strategies.
• Variability in recurrence rates among endoscopists suggests a need for enhanced predictive capabilities.

Purpose of the Study:

• To assess endoscopists' ability to predict polyp recurrence post-EMR by evaluating images of mucosal defects.
• To determine if experience level influences the accuracy of recurrence prediction.
• To explore the potential of image-based assessment in reducing EMR recurrence rates.

Main Methods:

• An online survey was designed presenting 30 post-EMR defect images for evaluation.
• Endoscopists indicated their prediction of recurrence for each image, assuming complete resection.
• Participants were scored based on accuracy compared to findings at first surveillance colonoscopy.

Main Results:

• 124 endoscopists participated, achieving an overall accuracy of 70% in predicting recurrence.
• No significant difference in predictive accuracy was observed between experienced and less experienced endoscopists (71% vs. 69%).
• Respondents demonstrated a 53.4% certainty level in their predictions.

Conclusions:

• Endoscopists can reasonably predict recurrence after presumed complete EMR by scrutinizing images of mucosal defects.
• Thorough inspection of post-EMR defects is crucial for identifying areas at risk of recurrence.
• This predictive capability may lead to earlier intervention and reduced overall recurrence rates.