Optical Diagnosis of Colorectal Polyps: Recent Developments

  • Roupen Djinbachian
  • Anne-Julie Dubé
  • Daniel von RentelnEmail author
Colon (J Anderson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Colon


Purpose of review

Optical diagnosis of diminutive colorectal polyps has been recently proposed as an alternative to histopathologic diagnosis. Recent developments in imaging techniques, new classification systems, and the use of artificial intelligence have allowed for increased viability of optical diagnosis. This review provides an up-to-date overview of optical diagnosis recommendations, classifications, outcomes, and recent developments.

Recent findings

There are currently seven major classification systems and three major society recommendations for quality benchmarks for optical diagnosis of diminutive polyps. The NICE classification has been extensively studied and meets quality benchmarks for most imaging techniques but does not allow for the diagnosis of sessile serrated polyps (SSPs). The SIMPLE classification has met quality benchmarks for NBI and i-Scan and allows for the diagnosis of SSPs. Other classification systems need to be further studied to validate effectiveness. Computer-assisted diagnosis of colorectal polyps is a very promising recent development with first studies showing that society-recommended quality benchmarks for real-time colonoscopies on patients are being met. Limitations include a non-negligible percentage of failure to diagnose, low specificity, and low number of real-time diagnostic studies. More research needs to be performed to further understand the value of artificial intelligence for optical polyp diagnosis.


Optical diagnosis of diminutive colorectal polyps is currently a viable strategy for experienced endoscopists using validated classifications and imaging-enhanced endoscopy. Artificial intelligence–based diagnosis could make optical diagnosis widely applicable but is currently in its early developmental stage.


Optical diagnosis Endoscopy Colonoscopy Colorectal cancer Colorectal polyps Deep learning Resect and discard Endoscopic imaging 



Artificial intelligence


American Society for Gastrointestinal Endoscopy


Computer-aided diagnostic


Blue light imaging


European Society of Gastrointestinal Endoscopy


Fujinon intelligent color enhancement


Fecal immunochemical test


Narrow-band imaging


National Institute for Health and Care Excellence

NICE classification

NBI International Colorectal Endoscopic Classification


Negative predictive value


Optivista optical enhancement


Sessile serrated polyp


Sessile serrated adenoma


Workgroup on serrAted polypS and Polyposis


Author contributions

Roupen Djinbachian: literature review, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.Anne-Julie Dubé: analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.Daniel von Renteln: study concept and design, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content.

Compliance with Ethical Standards

Conflict of Interest

Roupen Djinbachian declares that he has no conflict of interest. Anne-Julie Dubé declares that she has no conflict of interest. Daniel von Renteln is supported by a “Fonds de Recherche du Québec Santé” career development award and has received consultation fees from Boston Scientific and research funding from ERBE, Ventage and Pentax.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Supplementary material

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Roupen Djinbachian
    • 1
    • 2
  • Anne-Julie Dubé
    • 1
    • 2
  • Daniel von Renteln
    • 2
    • 3
    Email author
  1. 1.Faculty of MedicineUniversity of MontrealMontrealCanada
  2. 2.Montreal University Hospital Research Center (CRCHUM)MontrealCanada
  3. 3.Division of GastroenterologyMontreal University Hospital Center (CHUM)MontrealCanada

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