| 1. |
- Rubio, Carlos A., et al.
(författare)
-
Assessing the Size of Polyp Phantoms in Tandem Colonoscopies
- 2009
-
Ingår i: Anticancer Research. - 0250-7005 .- 1791-7530. ; 29:5, s. 1539-1545
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The size of colorectal neoplastic polyps is important for their clinical management. Materials and Methods: The size of 12 polyp phantoms was assessed in tandem colonoscopies carried out by 7 endoscopists differing in years of clinical endoscopical experience. The endoscopists measured, with (n=5) or without (n=2) the aid of open forceps, the largest diameter of 12 polyp phantoms. Measurements in two independent trials were compared with the gold standard-size assessed at The Department Of Production Engineering, The Royal Institute of Technology. Results: In tandem trials, 99.4% (167/168) of the measurements underscored the gold standard size. In the 1st trial, the size in all 84 measurements was underestimated by -40% (range -34% to -45%) and in the 2nd trial the size in 83 of the 84 measurements was underestimated by -34% (range -24% to -42%). Neither the age of the participant, nor the years of experience with clinical endoscopy improved the results obtained. The participants significantly underestimated larger devices (>= 20 mm) whereas the smallest "polyps" were also underestimated, but with a lower degree of inaccuracy. The absolute difference between the golden standard size and the mean of all measurements performed on each polyp in 167 out of 168 measurements followed a regular downward trend. The volume of the devices was one of the confounding factors in size assessment. When compared to the gold standard size, the larger the "polyp" size, the higher the degree of underestimation. This may be crucial considering that the risk for colorectal adenomas to shelter an invasive growth is 46%, for adenomas measuring >= 2 cm, a limit accepted as a guideline worldwide for the management of patients with large colorectal polyps. Conclusion: Considering the clinical implications of the results obtained, the possibility of developing a method that would allow the assessment of the true size of polyps in clinical colonoscopy, is being explored.
|
|
| 2. |
- Rubio, Carlos A., et al.
(författare)
-
Reliability of the reported size of removed colorectal polyps
- 2006
-
Ingår i: Anticancer Research. - 0250-7005 .- 1791-7530. ; 26:6C, s. 4895-4899
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The size of colorectal polyps is important in the clinical management of these lesions. Aim: To audit the accuracy in calculating the size of polyps by various specialists. Materials and Methods: Eighteen pathologists and four surgeons measured, with a conventional millimetre ruler, the largest diameter of 12 polyp phantoms. The results of two independent measurements (two weeks apart) were compared with the gold standard-size assessed at The Royal Institute of Technology, Sweden. Results: Thirty-one percent (83/264-trial 1) and 33% (88/264-trial 2) of the measurements underestimated or overestimated the gold standard size by > 1 mm. Of the 22 experienced participants, 95% (21/22-trial 1) and 91% (20/22-trial 2) misjudged by > 1 mm the size of one or more polyps. Values given by 13 participants (4.9%) in trial I and by 15 participants (5.7%) in trial 2, differed by ! 4 mm from the gold standard size. In addition, a big difference between the highest and the lowest values was recorded in some polyps (up to 11.4 mm). Those disparate values were regarded as a human error in reading the scale on the ruler. Conclusion: Using a conventional ruler (the tool of pathologists worldwide) unacceptably high intra-observer and inter-observer variations in assessing the size of polyp-phantoms was found. The volume and the shape of devices, as well as human error in reading the scale of the ruler were confounding factors in size assessment. In praxis, the size is crucial in the management of colorectal polyps. Considering the clinical implications of the results obtained, the possibility of developing a method that will allow assessment of the true size of removed clinical polyps is being explored.
|
|
| 3. |
- Suzuki, Chikako, et al.
(författare)
-
Assessing polyp size by improved digitalized computed tomography (CT)
- 2008
-
Ingår i: Anticancer Research. - 0250-7005 .- 1791-7530. ; 28:3B, s. 1911-1915
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The size of colorectal polyps is important in the clinical management of these lesions. When using a conventional ruler (the tool of pathologists worldwide), we have previously found unacceptably high intra- and inter-observer variations in assessing the size of phantom polyps. The aim of this study was to assess the size of 12 phantom polyps by computed tomography (CT). Materials and Methods: The size of phantom polyps as assessed by CT was compared to the gold standard size (GSS) measured at The Royal Institute of Technology, Stockholm, Sweden. Results: In 33.3% (n=4) of the 12 polyps and in 41.7% (n=25) of the 60 measurements, the mean CT size under- or overestimated the GSS by more than 1 mm. In 15%, or in 9 of the 60 measurements, the CT size was under- or overestimated by more than 2 mm. In polyp #5 the GSS size was 8.41 mm where the expected cancer-risk in adenomas is 1%. But 3 out of 5 CT measurements were >10 mm, where the expected cancer-risk in adenomas is 10%. In polyp #10 the GSS size was 10.20 mm where the expected cancer-risk is 10%. But 2 out of 5 CT measurements were <10 mm where the expected risk is only 1%. Conclusion: The size assessed by CT was more reliable than that obtained with a millimetre ruler using the same devices, inasmuch as the disparate individual deviation-values found with the latter method were avoided. The volume and the shape of the devices influenced size assessment of phantom polyps by CT.
|
|
| 4. |
|
|
