Colon polyp characterization (morphology and mucosal patterns): clinical application and techniques

: The endoscopic treatment of neoplastic colorectal lesions has evolved over time to include technically challenging methods such as endoscopic submucosal dissection (ESD), which is slowly gaining traction in the U.S. after relatively widespread implementation in Japan. This review broadly covers the utility and main characteristics of several modalities for the endoscopic diagnosis and treatment of colorectal polyps including white light imaging (WLI), chromoendoscopy, and narrow band imaging (NBI). The increasing utilization of these techniques has unearthed a need for comprehensive and accurate classification systems of assessment, such as Kudo’s pit pattern, the Paris classification, NBI International Colorectal Endoscopic (NICE) classification, and the more recent Japan NBI Experts Team (JNET) classification. The inception and current impact of magnifying endoscopy is also considered, as it has transformed the endoscopist’s ability to inspect microsurfaces and critically evaluate mucosal microstructures to attain an endoscopic prediagnosis. Though there are many clear advantages to existing methods of optical diagnosis, this space has not been devoid of potential problems, and the benefits as well as shortcomings are described herein. The current literature surrounding some promising applications of artificial intelligence (AI) in the detection and management of polyps, as well as in the screening of colorectal cancer (CRC), is also discussed.