Endoscopy 2020; 52(S 01): S49-S50
DOI: 10.1055/s-0040-1704153
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 14:30 – 16:00 Polyp forensics: Colon advanced Wicklow Meeting Room 3 Imaging 2
© Georg Thieme Verlag KG Stuttgart · New York

CLINICAL VALIDATION OF BLI ADENOMAS SERRATED INTERNATIONAL CLASSIFICATION (BASIC) FOR RESECT AND DISCARD STRATEGY FOR DIMINUTIVE COLORECTAL POLYPS (BIRD STUDY)

E Rondonotti
1   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
C Hassan
2   Nuovo Regina Margherita Hospital, Digestive Endoscopy, Rome, Italy
,
A Andrealli
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
,
S Paggi
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
,
A Amato
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
,
L Scaramella
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
4   Università degli Studi di Milano, Dipartimento di Fisiopatologia Medico-chirurgica e dei Trapianti, Milano, Italy
,
A Repici
5   Humanitas Clinical and Research Center and Humanitas University, Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano, Italy
,
F Radaelli
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available ateRef
 
 

    Aims Blue Light Imaging (BLI) Adenomas Serrated International Classification (BASIC) has been shown to accurately predict histology of ≤10 mm colorectal polyps in an artificial setting with BLI. Study aim: to validate BASIC in a clinical setting by using as reference standard the thresholds recommended by the American Society for Gastrointestinal Endoscopy for resect and discard (R&D) strategy.

    Methods Consecutive outpatients referred for screening colonoscopy were included. Six endoscopists trained in BASIC participated in the study. All detected diminutive polyps were real-time BLI-characterized as adenoma or non-adenoma according to BASIC. All polyps were removed and sent for histopathology evaluation. Two thresholds were set:

    I) a ≥90% accuracy in surveillance intervals prediction based on high-confidence predictions

    of ≤ 5mm polyps (and pathology for the others);

    II) a ≥90% negative predictive value for ≤ 5mm rectosigmoid polyps characterized with high-confidence.

    The post-polypectomy surveillance intervals were based on both US Multisociety Task Force (USMSTF) and European Society of Gastrointestinal Endoscopy (ESGE) recommendations.

    Results 333 patients (mean age±SD: 62.7 ± 8.1 years; M/F: 176/157) were included. BASIC accuracy in 748 ≤ 5 mm polyps was 89% (95%CI: 85.9-90.6). The BLI-directed post-polypectomy surveillance interval was correctly predicted in 90% (95%CI: 86-93%) and in 96% (95%CI: 93-97%) of patients, according to USMSTF and ESGE recommendations, respectively. Out of 748 ≤ 5 mm polyps, 334 were located in the rectosigmoid and 302 (90%) assessed with high-confidence; the negative predictive value for adenomatous histology was 91% (95CI %: 85-95%).

    Conclusions The adoption of BASIC classification in clinical practice succeeded to match both of the reference thresholds for R&D strategy. (ClinicalTrialRegistrationNumber: NCT03746171)