Pub Date : 2025-12-16DOI: 10.1016/j.gie.2025.12.268
Mohamed S Elgendy, Mohamed Rifai, Amira M Taha, Islam Rajab, Abdulrahman Maged, Mohamed A Elgamasy, Hosam I Taha, Mohamed Abuelazm, Babu P Mohan, Douglas G Adler
Background and aims: Accurate polyp measurement is vital for colorectal cancer treatment and surveillance. Traditional methods are often unreliable. The FDA-approved Virtual Scale Endoscopy (VSE) provides real-time, laser-calibrated overlays to improve size measurements. This meta-analysis evaluated the diagnostic accuracy of VSE compared with conventional methods: visual assessment (VA), snare, and biopsy forceps.
Methods: We conducted a pairwise meta-analysis comparing VSE and VA, along with a frequent network meta-analysis (NMA) assessing VSE, VA, snare, and forceps retrieved from PubMed, Cochrane, Web of Science, Embase, WPRIM, and Scopus until January 2025. Risk ratios (RRs) and mean differences (MDs) were computed with 95% confidence intervals (CIs). SUCRA analysis ranked interventions.
Prospero id: CRD420251024644 RESULTS: Eleven studies were included, comprising 1,581 polyps across six clinical and five pre-clinical studies. In pairwise analysis, VSE significantly improved measurement accuracy compared to VA (MD 14.52%; 95% CI [10.35-18.70]) and reduced total misclassifications (54.3% vs 73.6%; RR 0.64; 95% CI [0.42-0.97]). In clinical subgroups, VSE markedly reduced overestimation rates (22.5% vs 41.5%; RR 0.52; 95% CI [0.44-0.63]). NMA confirmed VSE as the top-ranked modality for minimizing total misclassification (SUCRA 100%), outperforming snare, forceps, and VA. No overall differences were detected in total over- or underestimation.
Conclusions: VSE significantly improves polyp sizing accuracy compared to VA, snare, and forceps across both clinical and pre-clinical settings. NMA supports VSE as the top-ranking modality, suggesting its potential to enhance decision-making in polypectomy and surveillance. Larger multi-center trials are needed for validation.
背景和目的：准确的息肉测量对结直肠癌的治疗和监测至关重要。传统的方法往往不可靠。fda批准的虚拟尺度内窥镜（VSE）提供实时，激光校准的覆盖，以改善尺寸测量。本荟萃分析评估了VSE与常规方法（视觉评估（VA）、圈套和活检钳）的诊断准确性。方法：我们对VSE和VA进行了两两荟萃分析，并对从PubMed、Cochrane、Web of Science、Embase、WPRIM和Scopus检索到的VSE、VA、圈套和钳进行了频繁的网络荟萃分析（NMA），直到2025年1月。以95%置信区间（ci）计算风险比（rr）和平均差异（MDs）。SUCRA分析对干预措施进行了排名。结果：纳入了11项研究，包括6项临床研究和5项临床前研究的1,581例息肉。在成对分析中，与VA相比，VSE显著提高了测量精度（MD为14.52%;95% CI[10.35-18.70]），减少了总误分类（54.3% vs 73.6%； RR为0.64;95% CI[0.42-0.97]）。在临床亚组中，VSE显著降低了高估率（22.5% vs 41.5%; RR 0.52; 95% CI[0.44-0.63]）。NMA证实VSE是最大限度减少总误分类（SUCRA 100%），优于圈套，钳和VA的第一种方式。在总高估或低估方面没有发现总体差异。结论：在临床和临床前设置中，与VA、圈套和钳相比，VSE显著提高了息肉大小的准确性。NMA支持VSE作为首选模式，表明它有可能提高息肉切除术和监测的决策能力。需要更大规模的多中心试验来验证。
{"title":"Accuracy of Virtual Scale Endoscopy in Colorectal Polyp Size Measurement: A GRADE-Assessed Pairwise and Network Meta-Analysis.","authors":"Mohamed S Elgendy, Mohamed Rifai, Amira M Taha, Islam Rajab, Abdulrahman Maged, Mohamed A Elgamasy, Hosam I Taha, Mohamed Abuelazm, Babu P Mohan, Douglas G Adler","doi":"10.1016/j.gie.2025.12.268","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.268","url":null,"abstract":"<p><strong>Background and aims: </strong>Accurate polyp measurement is vital for colorectal cancer treatment and surveillance. Traditional methods are often unreliable. The FDA-approved Virtual Scale Endoscopy (VSE) provides real-time, laser-calibrated overlays to improve size measurements. This meta-analysis evaluated the diagnostic accuracy of VSE compared with conventional methods: visual assessment (VA), snare, and biopsy forceps.</p><p><strong>Methods: </strong>We conducted a pairwise meta-analysis comparing VSE and VA, along with a frequent network meta-analysis (NMA) assessing VSE, VA, snare, and forceps retrieved from PubMed, Cochrane, Web of Science, Embase, WPRIM, and Scopus until January 2025. Risk ratios (RRs) and mean differences (MDs) were computed with 95% confidence intervals (CIs). SUCRA analysis ranked interventions.</p><p><strong>Prospero id: </strong>CRD420251024644 RESULTS: Eleven studies were included, comprising 1,581 polyps across six clinical and five pre-clinical studies. In pairwise analysis, VSE significantly improved measurement accuracy compared to VA (MD 14.52%; 95% CI [10.35-18.70]) and reduced total misclassifications (54.3% vs 73.6%; RR 0.64; 95% CI [0.42-0.97]). In clinical subgroups, VSE markedly reduced overestimation rates (22.5% vs 41.5%; RR 0.52; 95% CI [0.44-0.63]). NMA confirmed VSE as the top-ranked modality for minimizing total misclassification (SUCRA 100%), outperforming snare, forceps, and VA. No overall differences were detected in total over- or underestimation.</p><p><strong>Conclusions: </strong>VSE significantly improves polyp sizing accuracy compared to VA, snare, and forceps across both clinical and pre-clinical settings. NMA supports VSE as the top-ranking modality, suggesting its potential to enhance decision-making in polypectomy and surveillance. Larger multi-center trials are needed for validation.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.gie.2025.12.267
Fares Ayoub, Vinshi Khan, Shilpa Jain, Roshan Raza, Mimi Tan, Noor Zabad, Tara Keihanian, Jordan Sparkman, Salmaan Jawaid, Robert J Sealock, Wasif Abidi, Kalpesh Patel, Mohamed O Othman
Background & aims: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is widely used to evaluate solid pancreatic lesions (SPL). While, traditionally, samples are sent for cytopathological evaluation in cytology media, histopathologic analysis may offer advantages in centers without on-site cytopathologists.
Methods: We conducted a multicenter, prospective study of EUS-FNB samples from patients with SPLs, submitted for histopathologic evaluation with macroscopic on-site evaluation (MOSE). Diagnostic accuracy was compared to a retrospective cohort whose samples were evaluated cytologically.
Results: A total of 129 patients were included (46 histopathology, 83 cytology). Diagnostic accuracy was comparable between arms (93.5% vs. 90.4%, p=0.544). Fewer needle passes were needed in the histopathology arm (p=0.045), and no samples in the histopathology arm were inadequate on MOSE.
Conclusion: Histopathologic analysis of EUS-FNB samples provides diagnostic accuracy comparable to cytology and supports broader adoption in settings without cytopathologists.
{"title":"Diagnostic yield of EUS-guided fine-needle biopsy of solid pancreatic lesions with tissue sent directly in formalin for histopathological evaluation compared to cytology: a multi-center prospective pilot study.","authors":"Fares Ayoub, Vinshi Khan, Shilpa Jain, Roshan Raza, Mimi Tan, Noor Zabad, Tara Keihanian, Jordan Sparkman, Salmaan Jawaid, Robert J Sealock, Wasif Abidi, Kalpesh Patel, Mohamed O Othman","doi":"10.1016/j.gie.2025.12.267","DOIUrl":"https://doi.org/10.1016/j.gie.2025.12.267","url":null,"abstract":"<p><strong>Background & aims: </strong>Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is widely used to evaluate solid pancreatic lesions (SPL). While, traditionally, samples are sent for cytopathological evaluation in cytology media, histopathologic analysis may offer advantages in centers without on-site cytopathologists.</p><p><strong>Methods: </strong>We conducted a multicenter, prospective study of EUS-FNB samples from patients with SPLs, submitted for histopathologic evaluation with macroscopic on-site evaluation (MOSE). Diagnostic accuracy was compared to a retrospective cohort whose samples were evaluated cytologically.</p><p><strong>Results: </strong>A total of 129 patients were included (46 histopathology, 83 cytology). Diagnostic accuracy was comparable between arms (93.5% vs. 90.4%, p=0.544). Fewer needle passes were needed in the histopathology arm (p=0.045), and no samples in the histopathology arm were inadequate on MOSE.</p><p><strong>Conclusion: </strong>Histopathologic analysis of EUS-FNB samples provides diagnostic accuracy comparable to cytology and supports broader adoption in settings without cytopathologists.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.gie.2025.10.019
Celine B E Busch, Annieke C G van Baar
{"title":"Response.","authors":"Celine B E Busch, Annieke C G van Baar","doi":"10.1016/j.gie.2025.10.019","DOIUrl":"https://doi.org/10.1016/j.gie.2025.10.019","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.gie.2025.10.028
Archit Garg, Arkady Broder, Douglas G Adler
{"title":"Response.","authors":"Archit Garg, Arkady Broder, Douglas G Adler","doi":"10.1016/j.gie.2025.10.028","DOIUrl":"https://doi.org/10.1016/j.gie.2025.10.028","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.gie.2025.10.018
Sahib Singh, Babu P Mohan, Douglas G Adler
{"title":"Response.","authors":"Sahib Singh, Babu P Mohan, Douglas G Adler","doi":"10.1016/j.gie.2025.10.018","DOIUrl":"https://doi.org/10.1016/j.gie.2025.10.018","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.gie.2025.11.039
Molly Orlick, Tina Boortalary, Faisal Kamal, Alexander Schlachterman
{"title":"Novel Use of Rigidizing Overtube for Direct Endoscopic Necrosectomy","authors":"Molly Orlick, Tina Boortalary, Faisal Kamal, Alexander Schlachterman","doi":"10.1016/j.gie.2025.11.039","DOIUrl":"https://doi.org/10.1016/j.gie.2025.11.039","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"28 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145657185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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