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 as  Duke staging system  Duke‘s modified staging system  TNM staging system  Pit 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 typeCharacteristics Iroundish pits IIstellar or papillary pits III Ssmall roundish or tubular pits (smaller than type I pits) III Llarge roundish or tubular pits (larger than type I pits) IVbranch-like or gyrus-like pits Vnon-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