Raf Bisschops

Raf Bisschops
KU Leuven | ku leuven · Gastroenterology

M.D. , PhD.

About

430
Publications
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Publications

Publications (430)
Article
Background and aims Current surveillance for Barrett’s esophagus (BE), consisting of 4-quadrant random forceps biopsy (FB), has an inherent risk of sampling error. Wide-Area Transepithelial Sampling (WATS) may increase detection of high-grade dysplasia (HGD) and adenocarcinoma (EAC). In this multicenter, randomized trial, we aimed to evaluate WATS...
Article
Widespread adoption of optical diagnosis of colorectal neoplasia is prevented by suboptimal endoscopist performance and lack of standardized training and competence evaluation. We aimed to assess diagnostic accuracy of endoscopists in optical diagnosis of colorectal neoplasia in the framework of artificial intelligence (AI) validation studies. Lite...
Article
The European Society of Gastrointestinal Endoscopy (ESGE) presents a short list of performance measures for colonoscopy in inflammatory bowel disease (IBD) patients. Current performance measures for colonoscopy mainly focus on detecting (pre)malignant lesions. However, these performance measures are not relevant for all colonoscopy indications in I...
Article
Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Stat...
Article
Background and Objective: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) affecting the colon and the rectum characterized by a remitting-relapsing course. To detect mucosal inflammation associated with UC, histology is considered the most stringent criteria. In turn, histologic remission (HR) correlates with improved clinical outcom...
Article
Background and aims: Focal cryoballoon ablation (FCBA) is currently investigated for the treatment of Barrett's esophagus (BE) related neoplasia in a European multicenter study (Euro-Coldplay study). After inclusion of 28/107 patients, the initial dose of 10 seconds (s) was lowered to 8s. The current study aimed to compare the efficacy and safety...
Article
The European Society of Gastrointestinal Endoscopy and United European Gastroenterology have defined performance measures for upper and lower gastrointestinal, pancreaticobiliary, and small-bowel endoscopy. Quality indicators to guide endoscopists in the growing field of advanced endoscopy are also underway. We propose that equal attention is given...
Article
Main recommendations ESGE recommends that the evaluation of superficial gastrointestinal (GI) lesions should be made by an experienced endoscopist, using high definition white-light and chromoendoscopy (virtual or dye-based). ESGE does not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonanc...
Article
Full-text available
Background and aims: Seattle protocol biopsies for Barrett's Esophagus (BE) surveillance are labour intensive with low compliance. Dysplasia detection rates vary, leading to missed lesions. This can potentially be offset with computer aided detection. We have developed convolutional neural networks (CNNs) to identify areas of dysplasia and where t...
Article
Background & aims: The combination of endoscopic resection and radiofrequency ablation is the treatment of choice for eradication of Barrett's esophagus (BE) with dysplasia and/or early BE cancer. Currently, there are no evidence-based recommendations on how to survey patients after successful treatment, and most patients undergo frequent follow-u...
Article
Background and aims Endoscopic eradication therapy (EET) for Barrett’s esophagus (BE) related neoplasia is safe and leads to complete eradication in the majority of patients. However, a subgroup will experience a more complex treatment course with a risk for failure or disease progression. Early identification of these patients may improve patient...
Article
Background and study aims: Endoscopic mucosal resection (EMR) is the first-line treatment for large sessile and flat colorectal polyps in Western centres, however recurrence after EMR continues to be a challenge. The aim of this study is to assess efficacy, safety and recurrence rate of EMR in a tertiary centre and to identify risk factors for rec...
Article
Full-text available
Background and aims: A composite endoscopic-histologic remission is increasingly explored as an important endpoint in ulcerative colitis (UC). We investigated combined endoscopic-histologic remission for predicting clinical outcomes at 12 months compared with endoscopic remission alone using the high definition virtual chromoendoscopy (VCE) Paddin...
Article
Full-text available
Histological remission is evolving as an important treatment target in UC. We aimed to develop a simple histological index, aligned to endoscopy, correlated with clinical outcomes, and suited to apply to an artificial intelligence (AI) system to evaluate inflammatory activity. Methods Using a set of 614 biopsies from 307 patients with UC enrolled...
Article
Background Endoscopic and histologic activity are important therapeutic targets in ulcerative colitis (UC). The Paddington International Virtual ChromoendoScopy ScOre (VCE-PICaSSO)1 demonstrated that enhanced visualisation of subtle mucosal and vascular inflammatory changes correlated strongly with histology. However, without adequate training, the...
Article
Background Histological remission (HR) is evolving as a treatment target in ulcerative colitis (UC). Several histological indices have been developed, however, their widespread adoption beyond clinical trials is limited by practical difficulties and interobserver variability. Furthermore, the relative complexity of available scores hinders the deve...
Article
Full-text available
Background and study aims Fujifilm has developed a novel ELUXEO 7000 endoscope system that employs light-emitting diodes (LEDs) at four different wavelengths as light sources that enable blue light imaging (BLI), linked color imaging (LCI), and high-definition white-light endoscopy (HD-WLE). The aim of this study was to address the diagnostic accur...
Article
Background The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position...
Article
Introduction: The current therapy of neoplastic Barrett's esophagus (BE) consists of endoscopic resection plus ablation, with radiofrequency ablation as the best studied technique. This prospective trial assesses a potential alternative, namely hybrid argon plasma ablation. Methods: Consecutive patients with neoplastic BE undergoing ablation aft...
Conference Paper
Introduction Expert labelling of each frame in a polyp video is the most robust way for constructing a training set for deep learning, but this is very time-consuming and currently represents a major barrier for widespread implementation of AI in endoscopy. In this study, two alternative approaches are evaluated, an innovative semi-automated labell...
Article
Recommendations 1 ESGE suggests performing segmental biopsies (at least two from each segment), which should be placed in different specimen containers (ileum, cecum, ascending, transverse, descending, and sigmoid colon, and rectum) in patients with clinical and endoscopic signs of colitis. Weak recommendation, low quality of evidence. 2 ESGE recom...
Article
Background Increased awareness of gastric cancer risk, easy access to upper endoscopy, and high definition endoscopes with virtual chromoendoscopy may have led to the increase in early diagnosis of gastric cancer observed in recent years in Europe, which may be associated with improved survival. Currently, no data exist on the impact of early diagn...
Poster
Full-text available
Colonoscopy is the gold standard for colorectal cancer (CRC) screening, but: high miss rate due to important variability in adenoma detection rate (ADR)  Increase of ADR with 1% is decrease of interval CRC with 3%  CADe is a potential solution for quality improvement Aim Investigate and validate the clinical performance of a new CADe for colorect...
Poster
Full-text available
Small single center study comparing the B1 mouthpiece (Fujifilm) for upper GI endoscopy to a conventional mouthpiece for upper GI endoscopy
Article
Main Recommendations 1 ESGE recommends that, where there is a suspicion of eosinophilic esophagitis, at least six biopsies should be taken, two to four biopsies from the distal esophagus and two to four biopsies from the proximal esophagus, targeting areas with endoscopic mucosal abnormalities. Distal and proximal biopsies should be placed in separ...
Article
Main Recommendations The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize and enhance training in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS). This manuscript represents the outcome of a formal Delphi process resulting in an official Position Statement of the ESGE a...
Chapter
A common limitation to almost all state-of-the-art techniques for automated polyp detection and delineation is that they are based on still-frame analysis (Wang et al. 2018; Urban et al. 2018; Shin et al. 2018; Mohammed et al. 2018). Colonoscopy, however, is a video-based modality and an endoscopist will always use the contextual information from p...
Article
Objective: Respiratory compromise is a major cause of adverse events during procedural sedation; continuous monitoring is vital for identifying and halting decompensation. We performed a quality improvement investigation to assess patient safety during procedural sedation in gastroenterology and the impact of implementing capnography monitoring....
Article
Full-text available
Background and Aims One of the reasons that the optical diagnosis strategy for diminutive colorectal polyps has not yet been implemented is that the current competence criteria [PIVI] are difficult to use in daily practice. To provide guidance for setting alternative easy-to-adopt competence criteria, we determined the lowest proportion of diminuti...
Article
Full-text available
Objective Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with high-definition white light endoscopy (HD-WLE) for...
Article
Full-text available
Objective Hydrothermal duodenal mucosal resurfacing (DMR) is a safe, outpatient endoscopic procedure. REVITA-2, a double-blind, superiority randomised controlled trial, investigates safety and efficacy of DMR using the single catheter Revita system (Revita DMR (catheter and system)), on glycaemic control and liver fat content in type 2 diabetes (T2...
Article
Full-text available
Up to 20% of people worldwide develop gastrointestinal symptoms following a meal¹, leading to decreased quality of life, substantial morbidity and high medical costs. Although the interest of both the scientific and lay communities in this issue has increased markedly in recent years, with the worldwide introduction of gluten-free and other diets,...
Article
Background and Aims Intrapapillary capillary loops (IPCLs) are microvascular structures that correlate with invasion depth of early squamous cell neoplasia (ESCN) and allow accurate prediction of histology. Artificial intelligence may improve human recognition of IPCL patterns and prediction of histology to allow prompt access to endoscopic therapy...
Article
Background There is a lack of clinical studies to establish indications and methodology for tattooing, therefore technique and practice of tattooing is very variable. We aimed to establish a consensus on indications and appropriate techniques for colonic tattoo through a modified Delphi Process. Methods The baseline questionnaire was classified in...