Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019

Autor: Raf Bisschops, James E. East, Cesare Hassan, Yark Hazewinkel, Michał F. Kamiński, Helmut Neumann, Maria Pellisé, Giulio Antonelli, Marco Bustamante Balen, Emmanuel Coron, Georges Cortas, Marietta Iacucci, Mori Yuichi, Gaius Longcroft-Wheaton, Serguei Mouzyka, Nastazja Pilonis, Ignasi Puig, Jeanin E. van Hooft, Evelien Dekker
Přispěvatelé: Gastroenterology and Hepatology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Re-generation and cancer of the digestive system, APH - Quality of Care
Rok vydání: 2019
Předmět:
Zdroj: Endoscopy, 51, 1155-1179
Endoscopy, 51(12), 1155-1179. Georg Thieme Verlag
Endoscopy
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
Endoscopy, 51, 12, pp. 1155-1179
ISSN: 0013-726X
Popis: Main Recommendations 1 ESGE suggests that high definition endoscopy, and dye or virtual chromoendoscopy, as well as add-on devices, can be used in average risk patients to increase the endoscopist’s adenoma detection rate. However, their routine use must be balanced against costs and practical considerations.Weak recommendation, high quality evidence. 2 ESGE recommends the routine use of high definition systems in individuals with Lynch syndrome.Strong recommendation, high quality evidence. 3 ESGE recommends the routine use, with targeted biopsies, of dye-based pancolonic chromoendoscopy or virtual chromoendoscopy for neoplasia surveillance in patients with long-standing colitis.Strong recommendation, moderate quality evidence. 4 ESGE suggests that virtual chromoendoscopy and dye-based chromoendoscopy can be used, under strictly controlled conditions, for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps and can replace histopathological diagnosis. The optical diagnosis has to be reported using validated scales, must be adequately photodocumented, and can be performed only by experienced endoscopists who are adequately trained, as defined in the ESGE curriculum, and audited.Weak recommendation, high quality evidence. 5 ESGE recommends the use of high definition white-light endoscopy in combination with (virtual) chromoendoscopy to predict the presence and depth of any submucosal invasion in nonpedunculated colorectal polyps prior to any treatment. Strong recommendation, moderate quality evidence. 6 ESGE recommends the use of virtual or dye-based chromoendoscopy in addition to white-light endoscopy for the detection of residual neoplasia at a piecemeal polypectomy scar site. Strong recommendation, moderate quality evidence. 7 ESGE suggests the possible incorporation of computer-aided diagnosis (detection and characterization of lesions) to colonoscopy, if acceptable and reproducible accuracy for colorectal neoplasia is demonstrated in high quality multicenter in vivo clinical studies. Possible significant risks with implementation, specifically endoscopist deskilling and over-reliance on artificial intelligence, unrepresentative training datasets, and hacking, need to be considered. Weak recommendation, low quality evidence.
Databáze: OpenAIRE