Pit Pattern Classification in Colonoscopy

A short introduction

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

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

Colonoscopy (2)

diagnosis is based on some sort of classification or staging such asDuke staging systemDuke‘s modified staging systemTNM staging systemPit pattern classification

stage important for physician to choose the right treatment

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

Pit pattern classification (2)

different pit pattern types

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

Pit pattern classification (4)

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