Classification of image-enhanced endoscopy in colon tumors

Abstract

Colorectal cancer accounts for 10% of global cancer cases in each year, making accurate evaluation and resection crucial. Imaging-enhancedendoscopy helps differentiate between hyperplastic polyps and adenomas, guiding treatment decisions. Colon tumors are classifiedinto benign (e.g., serrated and adenomatous polyps) and malignant (e.g., adenocarcinomas). The Paris classification categorizessuperficial neoplastic lesions by morphology, while laterally spreading tumors are classified by size and growth pattern. Effective classificationaids in determining resectability and appropriate interventions for colon tumors, ultimately improving patient outcomes. Image-enhanced endoscopy improves colon tumor diagnosis using various techniques like dye, optical, and electronic methods. Kudo’s pitpattern categorizes lesions based on surface morphology using dye, while Sano, Jikei, and Hiroshima classifications focus on vascularpatterns using narrow-band imaging (NBI). The NBI International Colorectal Endoscopic (NICE) classification integrates these methodsto identify lesions, especially deep submucosal invasive cancers. The Workgroup Serrated Polyps and Polyposis (WASP) classificationtargets sessile serrated lesions, and the Japan NBI Expert Team (JNET) classification further refines adenoma categorization withlow- and high-grade adenoma. The Colorectal Neoplasia Endoscopic Classification to Choose the Treatment (CONECCT) classificationconsolidates multiple systems for comprehensive assessment, aiding in treatment decisions and potentially applicable to artificialintelligence for diagnostic validation across imaging modalities like linked color imaging, blue light imaging, or i-scan.