InFocus - Issue 4, October 2016
Scientific Update
Endoscopic innovations at UEG Week 2016 in Vienna
Roel Bogie, MD, PhD-student
Hao Ran Cheng, MD, PhD-student
Silvia Sanduleanu, MD, PhD, Principal Investigator CRC research
Division of Gastroenterology & Hepatology, Maastricht University Medical Center, The Netherlands
The 24th edition of the United European Gastroenterology week will take place between October 15th and 19th. A good moment to preview the endoscopic innovations we can expect to be highlighted during this congress. This year’s UEG is exciting, in particular with respect to neoplasm detection, because complete new technologies will be presented. We wish you a pleasant and informative UEG Week!
With the introduction of high-magnification endoscopes, endocytoscopy as a diagnostic method and tool was born. Neoplastic and inflammatory processes can be directly distinguished from normal mucosa without the need to wait for results of a biopsy (1). While some Olympus scopes have an integrated separate sensor for magnification, the PENTAX magnification colonoscopes have an optical zoom system. Another option is to use detached magnification probes through the instrumental channel. So, magnification of the mucosa becomes available through various systems to more and more endoscopists. The availability of validated classification systems for interpretation of the magnification images is essential for the clinical consequences of this diagnostic tool. We will hear more about this technique and the clinical implications at the UEGW (P1262, OP211).
Magnification endoscopy can also be combined with digital chromoendoscopy (OP401), a combination that in our opinion, enhances both of its typical features. Development and validation of general classifications for NBI and i-scan Optical Enhancement (OE) will continue (OP170, P0702, P0719). These techniques are not only useful for the recognition of dysplasia, but also for inflammation such as ulcerative colitis (P0170). The first experiences of using i-scan OE in the monitoring of non-erosive reflux disease and Barett’s disease will be presented (P0140, P0664). A new topic of this year’s UEG is the focus on automated analysis of endoscopy images. These systems are able to predict “on the spot” the most likely histopathological outcome of a lesion, thereby helping endoscopists in making decisions regarding treatment strategies (P0174, P1250, OP403, OP059). The first promising results of automated detection of dysplasia in Barrett’s esophagus have already been published (2).
Above mentioned techniques will not help to improve the visualization of lesions hidden behind colonic folds. Several devices for attachment to the endoscope have been introduced to stretch the colonic wall in order to visualize the complete mucosa. The Endocuff and the Endorings are two of such devices that have shown to have varying effects on the adenoma detection rate (ADR) (3-6). We are excited to hear and see what the latest insights on Endocuff (P0717, OP058, OP169, OP373) and EndoRings (OP372) will bring us. An alternative method to stretch the colonic wall is use of the G-EYE colonoscope (OP374), a conventional colonoscope with a balloon attached that can be in- and deflated during colonoscopy, which could improve the ADR drastically (7). We hope to hear more about the benefits and side effects of these and endoscopic accessories in general at the UEGW in Vienna (IP198).
A schedule of the above mentioned abstracts:
Day and time | Session | ID | Title, presenting author |
Monday | |||
10:30 – 17:00 | Poster: Endoscopy and Imaging I | P0140 | Detection of neoplasia in Barrett’s disease with image enhancement using OE– an early experience; John Sneha |
|
| P0170 | Beyond white light: embarking on the first experience with the new green-red-orange light optical enhancement magnification colonoscopy to define subtle inflammatory changes in Ulcerative Colitis patients; Marietta Iacucci |
|
| P0174 | Diagnostic ability of automated diagnosis system using endocytoscopy for invasive colorectal cancer; Kenichi Takeda |
14:22 – 14:34 | Improving the adenoma detection rate (E1) | OP058 | Endocuff-assisted colonoscopy outperforms conventional colonoscopy to detect missed-adenomas: European multicenter, randomized, back-to-back study; Konstantinos Triantafyllou |
14:34 – 14:46 |
| OP059 | The Diagnostic Ability of a Computer-aided Diagnosis System for Narrow-band Imaging Endocytoscopy Is Comparable to That of Expert Endoscopists; Masashi Misawa |
14:46 – 15:08 |
| IP197 | Impact of new generation of endoscopes; Thierry Ponchon |
15:08 – 15:30 |
| IP198 | Pros and cons of accessories for improving detection; Ralf Kiesslich |
Tuesday | |||
09:00 – 17:00 | Poster: Endoscopy and Imaging II | P0664 | Minimal esophageal lesions detected by digital chromoendoscopy using Optical enhancement system™ associated to high definition plus optical magnification in Non Erosive Reflux Disease (NERD); Carlos Robles-Medranda |
|
| P0717 | Higher number of small (<10mm) adenomas detected with Endocuff-assisted colonoscopy in a screening population; Lucas G Cavallaro |
8:54 – 9:06 | Improving detection of polyps (N2) | OP169 | Efficacy of Endocuff-assisted colonoscopy in the detection of colorectal polyps; Yoshiki Wada |
9:06 – 9:18 |
| OP170 | Development and validation of a simple classification system for in vivo diagnosis of colorectal polyps using the newly introduced Optical Enhancement (OE) technology; Helmut Neumann |
10:54 – 11:06 | Improving detection and treatment of colonic polyps (N2) | OP211 | Diagnostic characteristics of depressed type colorectal neoplasms in magnifying endoscopy and endocytoscopy; Shinei Kudo |
Wednesday | |||
9:00 – 14:00 | Poster: Endoscopy and Imaging III | P1250 | Computer-based automatic differentiation of neoplastic and non-neoplastic polyps with the application of deep structured learning algorithms of a convolutional neural network – preliminary results; Laszlo Madacsy |
|
| P1262 | Classification of cell nuclei morphology of EC findings in colorectal endocytoscopy; Toyoki Kudo |
10:54 – 11:06 | Improving quality of screening colonoscopy (N2) | OP372 | Endorings™ increases ADR even in high-risk screening colonoscopy: results of a single centre pilot study; Bu Hayee |
11:06 – 11:18 |
| OP373 | The first randomised controlled trial of Endocuff Vision® assisted colonoscopy versus standard colonoscopy for polyp detection in bowel cancer screening patients (E-CAP study); Rupam Bhattacharyya |
11:18 – 11:30 |
| OP374 | Increased adenoma detection rate by G-EYE high definition colonoscopy in comparison to standard high definition colonoscopy- a prospective randomized multicentre study; Haim Shirin |
11:50 – 12:00 | Abstracts on Fire: New Approaches to colorectal disease | OP403 | Artificial Intelligence (AI) in endoscopy--Deep learning for optical biopsy of colorectal polyps in real-time on unaltered endoscopic videos; Michael Francis Byrne |
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References:
1 Neumann H, Kudo SE, Kiesslich R, Neurath MF. Advanced colonoscopic imaging using endocytoscopy. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. 2015;27(2):232-8.
2 van der Sommen F, Zinger S, Curvers WL, Bisschops R, Pech O, Weusten BL, et al. Computer-aided detection of early neoplastic lesions in Barrett's esophagus. Endoscopy. 2016;48(7):617-24.
3 Biecker E, Floer M, Heinecke A, Strobel P, Bohme R, Schepke M, et al. Novel endocuff-assisted colonoscopy significantly increases the polyp detection rate: a randomized controlled trial. J Clin Gastroenterol. 2015;49(5):413-8.
4 Floer M, Biecker E, Fitzlaff R, Roming H, Ameis D, Heinecke A, et al. Higher adenoma detection rates with endocuff-assisted colonoscopy - a randomized controlled multicenter trial. PLoS One. 2014;9(12):e114267.
5 van Doorn SC, van der Vlugt M, Depla A, Wientjes CA, Mallant-Hent RC, Siersema PD, et al. Adenoma detection with Endocuff colonoscopy versus conventional colonoscopy: a multicentre randomised controlled trial. Gut. 2015.
6 Dik VK, Gralnek IM, Segol O, Suissa A, Belderbos TD, Moons LM, et al. Multicenter, randomized, tandem evaluation of EndoRings colonoscopy--results of the CLEVER study. Endoscopy. 2015;47(12):1151-8.
7 Halpern Z, Ishaq S, Neumann H, Dobosz M, Viale E, Hoffman A, et al. Su1210 G-EYE Colonoscopy Significantly Improves Adenoma Detection Rates-Initial Results of a Multicenter Prospective Cohort Study. Gastroenterology. 2014;146(5):S-402.
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