03/09/2026
Three questions before you resect a large non-pedunculated colorectal polyp.
1. Blink. Under white light, does it look worrying at first glance? Six gross features: spontaneous bleeding, extra redness, depression, fold deformation, ulceration, chicken-skin mucosa. Two or more is positive.
2. Demarcated area. Under virtual chromoendoscopy, does one region stand out from the rest of the lesion?
3. CRIS. Inside that area, do the vessels lose their regularity? Regular, regularly irregular, irregular. Only the first is reassuring.
A positive call is a cancer-risk flag: consider multidisciplinary discussion before piecemeal endoscopic resection.
The 54-second animation below walks through the sequence. It comes from a prospective, four-centre study led by Maria Eva Argenziano at UZ Gent, with assessors from trainee to expert scoring lesions live before resection. Results are in preparation for publication; we will share them here when they are out.
GIEQs — the international symposium for everyday endoscopy.