Imperial College London
Alternate

ProfessorZoltanTakats

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Analytical Chemistry
 
 
 
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Contact

 

+44 (0)20 7594 2760z.takats

 
 
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Location

 

Sir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mason:2019:10.14309/ajg.0000000000000156,
author = {Mason, SE and Poynter, L and Takats, Z and Darzi, A and Kinross, JM},
doi = {10.14309/ajg.0000000000000156},
journal = {American Journal of Gastroenterology},
pages = {1219--1230},
title = {Optical technologies for endoscopic real-time histologic assessment of colorectal polyps: a meta-analysis},
url = {http://dx.doi.org/10.14309/ajg.0000000000000156},
volume = {114},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Accurate, real-time, endoscopic risk stratification of colorectal polyps would improve decision-making and optimize clinical efficiency. Technologies to manipulate endoscopic optical outputs can be used to predict polyp histology in vivo; however, it remains unclear how accuracy has progressed and whether it is sufficient for routine clinical implementation. METHODS: A meta-analysis was conducted by searching MEDLINE, Embase, and the Cochrane Library. Studies were included if they prospectively deployed an endoscopic optical technology for real-time in vivo prediction of adenomatous colorectal polyps. Polyposis and inflammatory bowel diseases were excluded. Bayesian bivariate meta-analysis was performed, presenting 95% confidence intervals (CI). RESULTS: One hundred two studies using optical technologies on 33,123 colorectal polyps were included. Digital chromoendoscopy differentiated neoplasia (adenoma and adenocarcinoma) from benign polyps with sensitivity of 92.2% (90.6%-93.9% CI) and specificity of 84.0% (81.5%-86.3% CI), with no difference between constituent technologies (narrow-band imaging, Fuji intelligent Chromo Endoscopy, iSCAN) or with only diminutive polyps. Dye chromoendoscopy had sensitivity of 92.7% (90.1%-94.9% CI) and specificity of 86.6% (82.9%-89.9% CI), similarly unchanged for diminutive polyps. Spectral analysis of autofluorescence had sensitivity of 94.4% (84.0%-99.1% CI) and specificity of 50.9% (13.2%-88.8% CI). Endomicroscopy had sensitivity of 93.6% (85.3%-98.3% CI) and specificity of 92.5% (81.8%-98.1% CI). Computer-aided diagnosis had sensitivity of 88.9% (74.2%-96.7% CI) and specificity of 80.4% (52.6%-95.7% CI). Prediction confidence and endoscopist experience alone did not significantly improve any technology. The only subgroup to demonstrate a negative predictive value for adenoma above 90% was digital chromoendoscopy, making high confidence predictions of diminutive recto-sigmoid polyps. Chronologic meta-analyses show a
AU  - Mason,SE
AU  - Poynter,L
AU  - Takats,Z
AU  - Darzi,A
AU  - Kinross,JM
DO  - 10.14309/ajg.0000000000000156
EP  - 1230
PY  - 2019///
SN  - 1572-0241
SP  - 1219
TI  - Optical technologies for endoscopic real-time histologic assessment of colorectal polyps: a meta-analysis
T2  - American Journal of Gastroenterology
UR  - http://dx.doi.org/10.14309/ajg.0000000000000156
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30848728
UR  - http://hdl.handle.net/10044/1/70251
VL  - 114
ER  -
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