Measuring polyp size using a virtual scale endoscope: a video tutorial with clinical case demonstration
Bibliographic record
Abstract
Accurate real-time endoscopic assessment of colorectal polyp size plays a key role for selecting adequate post-polypectomy surveillance intervals or when choosing appropriate polypectomy techniques [ 1 ]. While visual estimation is the most commonly used method of measurement, there is marked interobserver variability. Biopsy forceps and ruler snares can be used as references for polyp size estimation, but are limited by being external devices that lengthen the duration of the endoscopy and increase the procedural cost [ 2 ] [ 3 ]. The virtual scale endoscope (VSE; Fujifilm, Tokyo, Japan) ([ Fig. 1 ]) is a new endoscope developed to provide real-time polyp size measurement during colonoscopy [ 4 ] [ 5 ]. The VSE is equipped with a red laser beam that projects a laser dot onto the mucosa. This dot changes position according to the distance between the tip of the endoscope and the target polyp ([ Fig. 1 ]; [ Video 1 ]). The laser dot must be positioned on the left center edge of the polyp. The software then detects the position of the laser dot through its reflection on the mucosa and displays the virtual scale on the right side ([ Fig. 2 ]; [ Video 1 ]). Best size estimation is obtained when the endoscope is positioned in front of the polyp. A distance of 4–30 mm between the endoscope and the target lesion must be maintained for accurate estimation of polyp size ([ Fig. 2 ]; [ Video 1 ]). One recent study has evaluated the feasibility of the VSE in an ex vivo experiment and a second ex vivo study has demonstrated that size measurement is more accurate when using the VSE compared with visual size estimation [ 4 ] [ 5 ]. Fig. 1 A visual representation of polyp size estimation using the distance between the endoscope tip and the polyp. Video 1 Video tutorial on the use of the virtual scale endoscope including an ex vivo demonstration and its use in a clinical setting for two colorectal polyps. Quality: mobile 360 480 720 Download Fig. 2 Examples of polyp size estimation with the virtual scale endoscope for: a a small in vivo polyp using the linear scale; b a small in vivo polyp using the circular scale; c a large ex vivo polyp using the linear scale; d a large ex vivo polyp using the circular scale. We present a visually assisted instruction guide on how to use the VSE and demonstrate its application in ex vivo and in vivo examples ([ Video 1 ]). The video tutorial discusses the most important considerations to achieve optimal polyp size measurements when using the VSE. Endoscopy_UCTN_Code_CCL_1AD_2AB Endoscopy E-Videos https://eref.thieme.de/e-videos Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. Processing charges apply (currently EUR 375), discounts and wavers acc. to HINARI are available. This section has its own submission website at https://mc.manuscriptcentral.com/e-videos Publication History Article published online: 28 October 2022 © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Comment to this article: Endoscopy E-Videos – recently published Endoscopy 2023; 55(03): 294-294 DOI: 10.1055/a-1998-4884
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.024 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".