Use of endocytoscopy for identification of sessile serrated adenoma/polyps and hyperplastic polyps by quantitative image analysis of the luminal areas

Yushi Ogawa; Shin-ei Kudo; Yuichi Mori; Nobunao Ikehara; Yasuharu Maeda; Kunihiko Wakamura; Masashi Misawa; Toyoki Kudo; Takemasa Hayashi; Hideyuki Miyachi; Atsushi Katagiri; Fumio Ishida; Haruhiro Inoue

doi:10.1055/s-0043-113562

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endoscopy 2017; 05(08): E769-E774
DOI: 10.1055/s-0043-113562

Original article

Use of endocytoscopy for identification of sessile serrated adenoma/polyps and hyperplastic polyps by quantitative image analysis of the luminal areas

Yushi Ogawa

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Shin-ei Kudo

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yuichi Mori

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Nobunao Ikehara

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Yasuharu Maeda

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Kunihiko Wakamura

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Masashi Misawa

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Toyoki Kudo

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Takemasa Hayashi

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Hideyuki Miyachi

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Atsushi Katagiri

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Fumio Ishida

¹Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

,

Haruhiro Inoue

²Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan

› Author Affiliations

Abstract

Background and study aims Recent studies that used magnifying chromoendoscopy and endocytoscopy (EC) to investigate endoscopic features of sessile serrated adenoma/polyps (SSA/Ps) suggested that a dilated crypt opening was an important indicator of SSA/Ps. However, no studies to date have measured the actual extent of dilatation. Hence, we investigated retrospectively the luminal areas using EC to determine a cutoff value for differentiating SSA/Ps from hyperplastic polyps (HPs).

Patients and methods A total of 101 lesions, including 25 SSA/Ps, 66 HPs, and 10 normal mucosal samples, assessed by an integrated-type EC were collected. For each lesion, 1 image that showed the widest lumen was selected and the average area of the contiguous 3 lumens were calculated. The cutoff value differentiating SSAPs from HPs was determined by receiver operating curve (ROC) analysis.

Results The mean luminal areas of SSA/Ps and HPs were 4152 μm² and 2117 μm², respectively. ROC analysis found that a luminal area cutoff of 3068 μm² had a sensitivity of 80.0 %, a specificity of 77.3 %, an accuracy of 78.0 %, and an area under the ROC curve of 0.865. Furthermore, a cutoff of ≥ 556 μm² was found to accurately distinguish between HPs and normal mucosa (sensitivity 98.5 %, specificity 100 %, accuracy 98.7 %, and AUC 0.998).

Conclusions EC analysis of the luminal area is useful for differentiating between SSAPs and HPs. This approach could be adapted for computer-aided diagnosis of SSA/P.

Full Text

References

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