Pit Pattern Classification in Colonoscopy

1
Pit Pattern Classification in Colonoscopy

• A short introduction

2
Colon cancer some facts

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

3
Colonoscopy (1)

• 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
• flexible, lighted instrument
• possibility to take pictures during colonoscopy
• magnifying colonoscope
• up to 150-fold magnification ? more details get
  uncovered

4
Colonoscopy (2)

• diagnosis is based on some sort of classification
  or staging such as
• Duke staging system
• Dukes modified staging system
• TNM staging system
• Pit pattern classification
• stage important for physician to choose the right
  treatment

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Pit pattern classification (1)

• 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

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Pit pattern classification (2)

• different pit pattern types

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Pit pattern classification (3)

• 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
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Pit pattern classification (4)

• but in real life classification is not really
  that easy

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Pit pattern Type I
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Pit pattern Type II
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Pit pattern Type IIIS
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Pit pattern Type IIIL
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Pit pattern Type IV
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Pit pattern Type V