Parikh, Neil D.Perl, DanielLee, Michelle H.Chang, Shannon S.Polydorides, Alexandros D.Moshier, ErinGodbold, JamesZhou, ElinorMitcham, JosephineRichards-Kortum, RebeccaAnandasabapathy, Sharmila2015-09-242015-09-242015Parikh, Neil D., Perl, Daniel, Lee, Michelle H., et al.. "In vivo classification of colorectal neoplasia using high-resolution microendoscopy: Improvement with experience." <i>Journal of Gastroenterology and Hepatology,</i> 30, no. 7 (2015) Wiley: 1155-1160. http://dx.doi.org/10.1111/jgh.12937.https://hdl.handle.net/1911/81717Background and Aims: High-resolution microendoscopy (HRME) is a novel, low-cost “optical biopsy” technology that allows for subcellular imaging. The study aim was to evaluate the learning curve of HRME for the differentiation of neoplastic from non-neoplastic colorectal polyps. Methods: In a prospective cohort fashion, a total of 162 polyps from 97 patients at a single tertiary care center were imaged by HRME and classified in real time as neoplastic (adenomatous, cancer) or non-neoplastic (normal, hyperplastic, inflammatory). Histopathology was the gold standard for comparison. Diagnostic accuracy was examined at three intervals over time throughout the study; the initial interval included the first 40 polyps, the middle interval included the next 40 polyps examined, and the final interval included the last 82 polyps examined. Results: Sensitivity increased significantly from the initial interval (50%) to the middle interval (94%, P = 0.02) and the last interval (97%, P = 0.01). Similarly, specificity was 69% for the initial interval but increased to 92% (P = 0.07) in the middle interval and 96% (P = 0.02) in the last interval. Overall accuracy was 63% for the initial interval and then improved to 93% (P = 0.003) in the middle interval and 96% (P = 0.0007) in the last interval. Conclusions: In conclusion, this in vivo study demonstrates that an endoscopist without prior colon HRME experience can achieve greater than 90% accuracy for identifying neoplastic colorectal polyps after 40 polyps imaged. HRME is a promising modality to complement white light endoscopy in differentiating neoplastic from non-neoplastic colorectal polyps.engThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by Wiley.Journal articleadenoma classificationcolorectal polypsmicroendoscopyhttp://dx.doi.org/10.1111/jgh.12937