- The European Society of Gastrointestinal Endoscopy (ESGE) has published updated guidelines for using advanced imaging to detect and differentiate colorectal neoplasias.
Why this matters
- With rollout of new advances in imaging, endoscopists have some guidance on applications and interpretations.
- High-definition endoscopy, with dye/virtual chromoendoscopy and add-on devices, is acceptable for adenoma detection in patients at average risk, considering costs, practicalities (weak recommendation/high-quality evidence).
- Routine use of high-definition systems in Lynch syndrome is recommended (strong/high-quality).
- Routine targeted biopsy or dye-based/virtual chromoendoscopy in long-standing colitis recommended (strong/moderate-quality).
- Virtual or dye-based chromoendoscopy OK under strict controls and with extensive experience for diagnosis of very small polyps (≤ 5 mm; weak/high-quality).
- High-definition white-light endoscopy+chromoendoscopy for characterizing submucosal invasion (strong/moderate-quality).
- Chromoendoscopy+white-light endoscopy for residual neoplasia at site of piecemeal polypectomy (strong/moderate-quality).
- Computer-aided diagnosis possible but carries significant implementation risks (weak/low-quality).