A new simplified classification system for optical diagnosis of small and diminutive colonic polyps (hyperplastic polyps, adenomas, sessile serrated adenomas) was developed, using the I-SCAN OE system or NBI.
This classification facilitates the diagnosis between the neoplastic and the non-neoplastic small colonic polyps, using only three endoscopic criteria: surface pattern, vessel pattern and lesion border. The authors sustain the superiority of this classification to NICE classification, because it reduces the interobserver differences in diagnosis, by not including color (an inaccurate criteria) as a parameter in the SIMPLE classification.
The article was published in Endoscopy in August 2018.
Non-neoplastic features | Neoplastic features | ||
Hyperplastic polyp | Sessile serrated adenoma/lesion | Adenoma | |
SURFACE PATTERN | Round pit | Open/dilated (dark) pit | Not round structure (ovalar, tubular, branched) |
VESSEL PATTERN | None isolated lacy | None isolated lacy | Thick vessels |
LESION BORDER | Regular | Irregular/indistinctive | Regular |