Implementation of real-time probe-based confocal laser endomicroscopy (pCLE) for differentiation of colorectal polyps during routine colonoscopy

Endoscopy International Open
Tim D G BelderbosPeter D Siersema

Abstract

Probe-based confocal laser endomicroscopy (pCLE) is used to differentiate between neoplastic and non-neoplastic colorectal polyps during colonoscopy. We aimed to assess the accuracy of two endoscopists starting to use real-time pCLE for differentiation of colorectal polyps and to determine the negative predictive value (NPV) for neoplasia in polyps ≤ 5 mm. Patients undergoing colonoscopy in a tertiary hospital were included in this prospective trial. After a training session, two colonoscopists assessed 50 polyps between August 2012 and April 2014. They sequentially used narrow-band imaging (NBI) and real-time pCLE to differentiate non-adenomatous, adenomatous, and carcinomatous polyps during colonoscopy. Histologic diagnosis by a gastrointestinal pathologist was the gold standard. Results were compared to post-hoc pCLE by a panel of gastroenterologists and pathologists. The accuracy of real-time pCLE was 76 %, compared to 73 % for NBI, and was not significantly different between the first 50 cases (74 %) and the last 50 cases (78 %, P  = 0.64). The accuracy in polyps > 5 mm was 87 % versus 59 % in polyps ≤ 5 mm ( P  = 0.04) and increased from 45 % (13/29) in poor quality images to 86 % (44/51) in fair quality images and 95 % (...Continue Reading

Citations

Mar 9, 2019·The American Journal of Gastroenterology·Sam E MasonJames M Kinross
Oct 4, 2019·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Zaheer Nabi, D Nageshwar Reddy
May 13, 2020·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Alan LoboRhodri Saunders
May 15, 2020·Surgical Endoscopy·Mazen R Al-MansourShawn Tsuda
May 21, 2019·Journal of Clinical Gastroenterology·Ben GloverNisha Patel

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Methods Mentioned

BETA
sedation

Software Mentioned

pCLE
Cellvizio
Statistical Packages for Social Sciences

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