High magnification chromoscopic colonoscopy (HMCC) allows examination of the colorectal pit pattern. This provides an "optical biopsy".
However, the accuracy of this technique when discriminating neoplastic from non-neoplastic lesions is unclear.
In this study, researchers from Sheffield, England, examined the efficacy of HMCC for the diagnosis of neoplasia in flat and depressed colorectal lesions.
Overall, 1850 patients underwent total colonoscopy between 2001 and 2003. All procedures were performed by a single endoscopist using the C240Z magnifying colonoscope.
The team classed all lesions using the Japanese Research Society guidelines, and pit pattern using the Kudos modified criteria.
Pit pattern appearances were then compared with histopathology.
|Diagnostic accuracy was not influenced by size or morphological classification of lesions.|
The researchers identified 1008 flat lesions.
The team calculated the sensitivity (98%) and specificity (92%) of HMCC in distinguishing non-neoplastic from neoplastic lesions.
They determined that when HMCC was used to differentiate non-invasive from invasive neoplastic lesions, sensitivity was poor (50%) with a specificity of 98%.
The researchers found that diagnostic accuracy was not influenced by size or morphological classification of lesions.
Dr Hurlstone's team concluded, "HMCC has a high overall accuracy at discriminating neoplastic from non-neoplastic lesions but is not 100% accurate".
"HMCC is a useful diagnostic tool in vivo but presently is not a replacement for histology".
"Requirements for further education and training in these techniques need to be addressed".