In vivo diagnostic accuracy of high resolution microendoscopy in differentiating neoplastic from non-neoplastic colorectal polyps: a prospective study

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dc.citation.firstpage68en_US
dc.citation.journalTitleThe American Journal of Gastroenterologyen_US
dc.citation.lastpage75en_US
dc.citation.volumeNumber109en_US
dc.contributor.authorParikh, Neilen_US
dc.contributor.authorPerl, Danielen_US
dc.contributor.authorLee, Michelle H.en_US
dc.contributor.authorShah, Brijenen_US
dc.contributor.authorYoung, Yukien_US
dc.contributor.authorChang, Shannon S.en_US
dc.contributor.authorShukla, Richaen_US
dc.contributor.authorPolydorides, Alexandros D.en_US
dc.contributor.authorMoshier, Erinen_US
dc.contributor.authorGodbold, Jamesen_US
dc.contributor.authorZhou, Elinoren_US
dc.contributor.authorMitchaml, Josephineen_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.authorAnandasabapathy, Sharmilaen_US
dc.date.accessioned2014-10-07T21:52:29Zen_US
dc.date.available2014-10-07T21:52:29Zen_US
dc.date.issued2014en_US
dc.description.abstractHigh-resolution microendoscopy (HRME) is a low-cost, ﾓoptical biopsyﾔ technology that allows for subcellular imaging. The purpose of this study was to determine the in vivo diagnostic accuracy of the HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps and compare it to that of high-definition white-light endoscopy (WLE) with histopathology as the gold standard. Three endoscopists prospectively detected a total of 171 polyps from 94 patients that were then imaged by HRME and classified in real-time as neoplastic (adenomatous, cancer) or non-neoplastic (normal, hyperplastic, inflammatory). HRME had a significantly higher accuracy (94%), specificity (95%), and positive predictive value (87%) for the determination of neoplastic colorectal polyps compared to WLE (65%, 39%, and 55%, respectively). When looking at small colorectal polyps (less than 10 mm), HRME continued to significantly outperform WLE in terms of accuracy (95% vs. 64%), specificity (98% vs. 40%) and positive predictive value (92% vs. 55%). These trends continued when evaluating diminutive polyps (less than 5 mm) as HRME's accuracy (95%), specificity (98%), and positive predictive value (93%) were all significantly greater than their WLE counterparts (62%, 41%, and 53%, respectively). In conclusion, this in vivo study demonstrates that HRME can be a very effective modality in the differentiation of neoplastic and non-neoplastic colorectal polyps. A combination of standard white-light colonoscopy for polyp detection and HRME for polyp classification has the potential to truly allow the endoscopist to selectively determine which lesions can be left in situ, which lesions can simply be discarded, and which lesions need formal histopathologic analysis.en_US
dc.identifier.citationParikh, Neil, Perl, Daniel, Lee, Michelle H., et al.. "In vivo diagnostic accuracy of high resolution microendoscopy in differentiating neoplastic from non-neoplastic colorectal polyps: a prospective study." <i>The American Journal of Gastroenterology,</i> 109, (2014) The American Journal of Gastroenterology: 68-75. http://dx.doi.org/10.1038/ajg.2013.387.en_US
dc.identifier.doihttp://dx.doi.org/10.1038/ajg.2013.387en_US
dc.identifier.urihttps://hdl.handle.net/1911/77435en_US
dc.language.isoengen_US
dc.publisherThe American Journal of Gastroenterologyen_US
dc.rightsThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyighted by The American Journal of Gastroenterology.en_US
dc.subject.keywordcolorectal polypsen_US
dc.subject.keywordadenoma classificationen_US
dc.subject.keywordmicroendoscopyen_US
dc.subject.keywordneoplasiaen_US
dc.subject.keyworddiagnostic accuracyen_US
dc.titleIn vivo diagnostic accuracy of high resolution microendoscopy in differentiating neoplastic from non-neoplastic colorectal polyps: a prospective studyen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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