July 13, 2022
High Adenoma Detection Rate in Colonoscopywith Computer-Aided Device.
A computer-aided device boosted adenoma detection in average-risk patients who underwent screening or surveillance colonoscopies for colorectal cancer (CRC), according to a randomized study.
The analysis included over 1300 patients and showed an increased number of adenomas per device-implemented colonoscopy compared to standard colonoscopies (1.05 vs 0.83, P=0.002), reported Aasma Shaukat, MD, MPH, of NYU Langone Medical Center in New York City, and colleagues.
The adenoma detection rate (ADR) was 47.8% with the device and 43.9% without the device (P=0.065). Additionally, there was no significant reduction in the true histology rate with the device (67.4% vs 71.7%, respectively, P for non-inferiority <0.001), nor the total number of non-neoplastic lesions (375 vs 284, respectively).
According to the authors, AI-assisted colorectal screening reduces CRC incidence and effectively detects neoplastic polyps. The device showed an increase in the detection of small lesions (1-4 mm), as well as larger lesions (5-9 mm). AI device-aided colonoscopy can improve adenoma miss rate by 26%.
The device in question detects colorectal polyps during high-definition white light colonoscopies using a real-time video feed with a visual indicator to assist endoscopists. The device has a 93.5% polyp-level true-positive rate and a 2.3% false-positive rate, according to Shaukat and colleagues.
The current study enrolled 1359 patients ages 60-61, 52-54% were men. Both arms had a minimal withdrawal time of 8 minutes, and the average procedure time was 15.4-15.8 minutes. All patients underwent standard colonoscopy (n=677) or colonoscopy with the device (n=682) from January to September 2021. Patients with a history of inflammatory bowel disease, a diagnostic indication for colonoscopy, or familial adenomatous polyposis were excluded from the trial.
Colonoscopies were performed by 22 experienced gastroenterologists who had a minimum ADR of 25%. Overall, 173 additional polyps were resected in the device group versus the standard group (1,136 vs 963). Use of the device led to a significant increase in the number of polyps resected in the proximal colon, but not the distal colon.
1. Shaukat A, et al "Computer-aided detection improves adenomas per colonoscopy for screening and surveillance colonoscopy: a randomized trial" Gastroenterology 2022; DOI: 10.1053/j.gastro.2022.05.028.
2. Zaina Hamza, Staff Writer, MedPage TodayJune 3, 2022 “Colonoscopy With a Computer-Aided Device Boosted Adenoma Detection”
3. Aasma Shaukat, MD, MPH, of NYU Langone Medical Center “Improvement in adenoma detection using a novel artificial intelligence-aided polyp detection device” CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(02): E263-E270 DOI: 10.1055/a-1321-1317