Pit Pattern Classification in Colonoscopy A short introduction

Pit Pattern Classification in Colonoscopy A short introduction

Colon cancer – some facts n American cancer society in the U. S. ¨ third most common cancer type among males ¨ fourth most common cancer type among females n risk increasing factors such as ¨ lifestyle n obesity, eating fat-high, smoking, alcohol, . . . ¨ also n medical history of family and genetic inheritance

Colonoscopy (1) n n regular colon examination important (especially for people of an age of 50+ years) Colonoscopy ¨ best currently available test to detect abnormalities within the colon ¨ done by using a so-called colonoscope n n flexible, lighted instrument possibility to take pictures during colonoscopy ¨ magnifying colonoscope n up to 150 -fold magnification more details get uncovered

Colonoscopy (2) n diagnosis is based on some sort of classification or staging such as ¨ Duke staging system ¨ Duke‘s modified staging system ¨ TNM staging system ¨ Pit pattern classification n stage important for physician to choose the right treatment

Pit pattern classification (1) n n n classification scheme developed by Kudo et al. based on the pit patterns of the colonic mucosa differentiation between 5 types of pit patterns: ¨ Type I to type V ¨ Type III has sub types III-S and III-L ¨ Type I and II are benign while type III to V are malignant tumorous lesion

Pit pattern classification (2) n different pit pattern types

Pit pattern classification (3) n characteristics of the different pit pattern types Pit pattern type Characteristics I roundish pits II stellar or papillary pits III S small roundish or tubular pits (smaller than type I pits) III L large roundish or tubular pits (larger than type I pits) IV branch-like or gyrus-like pits V non-structured pits

Pit pattern classification (4) n but in real life classification is not really that easy

Pit pattern – Type I

Pit pattern – Type II

Pit pattern – Type IIIS

Pit pattern – Type IIIL

Pit pattern – Type IV

Pit pattern – Type V