Caractérisation des lésions néoplasiques colorectales à l’aide de clips vidéo ou de photographies haute définition : étude comparative randomisée prospective

Médecine (gastro-entérologie, hépatologie)Introduction : aucune étude n'a évalué si les photos ou les vidéos étaient préférables pour la caractérisation des lésions néoplasiques colorectales (LNC). Méthodes : 20 LNC ont été montrées aux participants de l’étude, sous forme de 3-5 photos ou d'un clip vidéo. Les images étaient en lumière blanche haute définition, dont une au moins en chromoendoscopie virtuelle sans grossissement. Les participants devaient prédire la taille et le sous-type histologique des lésions à l’aide d’un formulaire et selon la classification CONECCT. L’histologique définitive et la taille étaient définies par l’anatomopathologie ou des critères combinés pour les lésions CONECCT IIC. Le critère de jugement principal était la prédiction correcte du sous-type histologique. Les critères de jugement secondaires étaient la prédiction correcte de la taille, les prédictions histologiques selon le sous-type et selon l'expérience (interne, gastro-entérologue (GE) ou expert). Résultats : les analyses ont porté sur 233 participants incluant 118 internes, 75 GE et 40 experts, répartis pour 47, 6% (111) d’entre eux dans le groupe photos et 52,4% dans le groupe vidéo (122). Les deux groupes étaient comparables. L’analyse statistique n’a pas permis de démontrer une meilleure prédiction histologique lorsque les opérateurs caractérisaient à l’aide de photos (57,3% de bonnes réponses en moyenne) ou à l’aide d’un clip vidéo (56,5%). Cependant, la taille des lésions était mieux évaluée sur photos (49.4% de bonnes réponses) que sur vidéo (45.8%, p = 0.03). La caractérisation des adénocarcinomes invasifs profonds était mieux faite par photos (47.8%) qu’en vidéo (41.1%, p = 0,02). Il n’y avait pas de différence selon l’expérience sauf chez les GE pour l’estimation de la taille (51,2% en photos, 44,3% en vidéos, p = 0,03). Conclusion : l’utilisation de la vidéo n’améliore pas la prédiction histologique en comparaison aux photographies. La taille des lésions est mieux évaluée à l’aide de photographies.Background : Accurate real-time characterization of colorectal neoplastic lesions (CNLs) during colonoscopy is important for deciding the appropriate treatment. No studies have evaluated whether still images or videoclips are better for characterization. We compared the histological predictions and size estimations of CNLs between two groups of gastroenterologists: one viewing still images and the other videoclips. Methods : Twenty CNLs were shown to the participants, in the format of either three to five still images or a videoclip. Three endoscopy experts obtained the images using high-definition white light and virtual chromoendoscopy without magnification. Stratified randomization was performed according to experience. For each lesion, participants had to assess the size and histological subtype according to the CONECCT classification (hyperplastic polyp (IH), sessile serrated lesion (IS), adenoma (IIA), high-risk adenoma or superficial adenocarcinoma (IIC), or deeply invasive adenocarcinoma (III)). The correct histological status and size were defined by the pathology reports or combined criteria between histology and expert opinion for high-risk adenoma or superficial adenocarcinoma (CONECCT IIC). Results : In total, 332 participants were randomized and 233 performed the characterization. The participants consisted of 118 residents, 75 gastroenterologists, and 40 endoscopy experts; 47.6% were shown still images and 52.4% videoclips. There was no statistically significant difference between the two groups in histological prediction, our primary endpoint. However, the lesion size was better assessed using still images than videoclips (p = 0.025). Conclusion : Videoclips do not improve the histological prediction of CNLs compared with still images. Size is better assessed using still images

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Video clips compared with high-definition still images for characterization of colorectal neoplastic lesions: a randomized comparative prospective study

Number: 8 PMID: 34447873 PMCID: PMC8383078Background and study aims  Accurate real-time characterization of colorectal neoplastic lesions (CNLs) during colonoscopy is important for deciding appropriate treatment. No studies have evaluated whether still images or video clips are better for characterization. We compared histological predictions and size estimations of CNLs between two groups of gastroenterologists: one viewing still images and the other viewing video clips. Materials and methods  Participants were shown 20 CNLs as either 3-5 still images or a video clip. Three endoscopy experts obtained the images using high-definition white light and virtual chromoendoscopy without magnification. Stratified randomization was performed according to experience. For each lesion, participants assessed the size and histological subtype according to the CONECCT classification (hyperplastic polyp [IH], sessile serrated lesion [IS], adenoma [IIA], high-risk adenoma or superficial adenocarcinoma [IIC], or deeply invasive adenocarcinoma [III]). The correct histological status and size were defined by the pathology reports or combined criteria between histology and expert opinion for high-risk adenoma or superficial adenocarcinoma (CONECCT IIC). Results  332 participants were randomized and 233 performed the characterization. Participants comprised 118 residents, 75 gastroenterologists, and 40 endoscopy experts; 47.6 % were shown still images and 52.4 % viewed video clips. There was no statistically significant difference between the two groups in histological prediction, our primary end point. However, the lesion size was better assessed using still images than video clips ( P  = 0.03). Conclusions  Video clips did not improve the histological prediction of CNLs compared with still images. Size was better assessed using still images