Digital morphometric characterization of mucosal surface lesion patterns under magnification colonoscopy.

Objective: To study quantified mucosal surface patterns of digitized colonoscopic images obtained with 17-40x magnification and chromoscopy of hyperplastic, adenomatous lesions and adenocarcinomas confirmed by histology.

Study Design: Morphometric measures were performed on at least 10 image files of each lesion and compared to normal mucosa at the same distance and area from each image. Thirty-seven hyperplastic lesions, 42 adenomas and 26 carcinomas from 105 patients were studied. Three morphometric characteristics were evaluated in lesions and normal mucosal surface area from each case: pit counts per area, pit diameter and pit area.

Results: Pit counts per area and pit area of lesions as compared to the normal mucosa of the same cases showed statistically significant differences in the 3 groups of lesions studied (p < 0.001).

Conclusion: Real-time morphometric evaluation is feasible during videocolonoscopy with magnification roughly equivalent to a 5x microscopic field. Automated evaluation of morphometric characteristics as part of Bayesian Belief Network software may prove a useful information source for the colonoscopist's diagnostic decision.