A computer-aided system improves the performance of endoscopists in detecting colorectal polyps: a multi-center, randomized controlled trial

Bibliographic Details
Title: A computer-aided system improves the performance of endoscopists in detecting colorectal polyps: a multi-center, randomized controlled trial
Authors: Heng Zhang, Qi Wu, Jing Sun, Jing Wang, Lei Zhou, Wei Cai, Duowu Zou
Source: Frontiers in Medicine, Vol 10 (2024)
Publisher Information: Frontiers Media S.A., 2024.
Publication Year: 2024
Collection: LCC:Medicine (General)
Subject Terms: computer-aided detection, artificial intelligence, colorectal polyps, colonoscopy, sensitivity, Medicine (General), R5-920
More Details: BackgroundUp to 45.9% of polyps are missed during colonoscopy, which is the major cause of post-colonoscopy colorectal cancer (CRC). Computer-aided detection (CADe) techniques based on deep learning might improve endoscopists’ performance in detecting polyps. We aimed to evaluate the effectiveness of the CADe system in assisting endoscopists in a real-world clinical setting.MethodsThe CADe system was trained to detect colorectal polyps, recognize the ileocecal region, and monitor the speed of withdrawal during colonoscopy in real-time. Between 17 January 2021 and 16 July 2021. We recruited consecutive patients aged 18–75 years from three centers in China. We randomized patients in 1:1 groups to either colonoscopy with the CADe system or unassisted (control). The primary outcomes were the sensitivity and specificity of the endoscopists. We used subgroup analysis to examine the polyp detection rate (PDR) and the miss detection rate of endoscopists.ResultsA total of 1293 patients were included. The sensitivity of the endoscopists in the experimental group was significantly higher than that of the control group (84.97 vs. 72.07%, p < 0.001), and the specificity of the endoscopists in these two groups was comparable (100.00 vs. 100.00%). In a subgroup analysis, the CADe system improved the PDR of the 6–9 mm polyps (18.04 vs. 13.85%, p < 0.05) and reduced the miss detection rate, especially at 10:00–12:00 am (12.5 vs. 39.81%, p < 0.001).ConclusionThe CADe system can potentially improve the sensitivity of endoscopists in detecting polyps, reduce the missed detection of polyps in colonoscopy, and reduce the risk of CRC.RegistrationThis clinical trial was registered with the Chinese Clinical Trial Registry (Trial Registration Number: ChiCTR2100041988).Clinical trial registrationwebsite www.chictr.org.cn, identifier ChiCTR2100041988.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2296-858X
Relation: https://www.frontiersin.org/articles/10.3389/fmed.2023.1341259/full; https://doaj.org/toc/2296-858X
DOI: 10.3389/fmed.2023.1341259
Access URL: https://doaj.org/article/507c4390063742d68689ceecc331878a
Accession Number: edsdoj.507c4390063742d68689ceecc331878a
Database: Directory of Open Access Journals
More Details
ISSN:2296858X
DOI:10.3389/fmed.2023.1341259
Published in:Frontiers in Medicine
Language:English