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Background and Study Aims <p>Accurate determination of colorectal polyp size is critical for surveillance recommendations and for generating reliable ground truth in artificial intelligence (AI) development. Visual estimation is imprecise, and no validated reference standard exists. We aimed to assess the accuracy and reproducibility of real-time digital microscopic measurement of fresh polypectomy specimens.</p> Patients and Methods <p>In this prospective study at the Centre hospitalier de l’Université de Montréal (CHUM), 70 polyps from 44 patients (mean age 65.4&#xa0;years; 52.3% female) were measured on-site using a calibrated digital microscope. Three independent raters, blinded to each other, obtained long- and short-axis measurements. The primary outcome was inter-rater reliability for long-axis measurements. Secondary outcomes included short-axis reliability, overall agreement, and classification (≤ 5&#xa0;mm vs. &gt; 5&#xa0;mm).</p> Results <p>Inter-rater reliability was excellent for both long-axis (ICC 0.941, 95% CI 0.914–0.961) and short-axis (ICC 0.943, 95% CI 0.917–0.962) measurements. Bland–Altman plots demonstrated mean differences near zero without systematic bias. Limits of agreement were within ± 1&#xa0;mm. When dichotomized at the 5&#xa0;mm threshold, agreement was perfect (κ = 1.0).</p> Conclusions <p>On-site digital microscopy provides highly reproducible and verifiable size data with photographic documentation. This method should be considered a practical reference standard for accurate polyp sizing research and AI model development, meeting regulatory expectations for traceable, auditable training data.</p>

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Digital Microscopy in the Endoscopy Suite: A Reference Standard for Colorectal Polyp Size Measurement

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Preslava Aleksieva,
  • Roupen Djinbachian,
  • Douglas K. Rex,
  • Heiko Pohl,
  • Neal Shahidi,
  • Sacha Mitchell,
  • Mohamed Zineddine Mahdadi,
  • Éric Cristea,
  • Megan Oleksiw,
  • Victoire Michal,
  • Claire Gefflot,
  • Daniel von Renteln

摘要

Background and Study Aims

Accurate determination of colorectal polyp size is critical for surveillance recommendations and for generating reliable ground truth in artificial intelligence (AI) development. Visual estimation is imprecise, and no validated reference standard exists. We aimed to assess the accuracy and reproducibility of real-time digital microscopic measurement of fresh polypectomy specimens.

Patients and Methods

In this prospective study at the Centre hospitalier de l’Université de Montréal (CHUM), 70 polyps from 44 patients (mean age 65.4 years; 52.3% female) were measured on-site using a calibrated digital microscope. Three independent raters, blinded to each other, obtained long- and short-axis measurements. The primary outcome was inter-rater reliability for long-axis measurements. Secondary outcomes included short-axis reliability, overall agreement, and classification (≤ 5 mm vs. > 5 mm).

Results

Inter-rater reliability was excellent for both long-axis (ICC 0.941, 95% CI 0.914–0.961) and short-axis (ICC 0.943, 95% CI 0.917–0.962) measurements. Bland–Altman plots demonstrated mean differences near zero without systematic bias. Limits of agreement were within ± 1 mm. When dichotomized at the 5 mm threshold, agreement was perfect (κ = 1.0).

Conclusions

On-site digital microscopy provides highly reproducible and verifiable size data with photographic documentation. This method should be considered a practical reference standard for accurate polyp sizing research and AI model development, meeting regulatory expectations for traceable, auditable training data.