1. Pit Pattern Classification in Colonoscopy A shortintroduction

2. 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

3. 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

4. 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

5. 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

6. Pit pattern classification (2) • different pit pattern types

7. Pit pattern classification (3) • characteristics of the different pit pattern types

8. Pit pattern classification (4) • but in real life classification is not really that easy

9. Pit pattern – Type I

10. Pit pattern – Type II

11. Pit pattern – Type IIIS

12. Pit pattern – Type IIIL

13. Pit pattern – Type IV

14. Pit pattern – Type V