期刊
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
卷 20, 期 7, 页码 1499-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2021.09.009
关键词
Adenoma Detection Rate; Adenoma Miss Rate; Computer-aided Detection; Deep Learning; Randomized Tandem Colonoscopy Study
资金
- Shanghai Municipal Science and Technology Major Project [2021SHZDZX0102]
- Major Program of National Natural Science Foundation of China [12090024]
- Shanghai Natural Science Foundation [21ZR1431000]
- Wision LLC
In a U.S. multicenter tandem colonoscopy randomized controlled trial, the use of a CADe-system was shown to decrease AMR and SSL miss rate while increasing first-pass APC compared to HDWL colonoscopy alone.
BACKGROUND & AIMS: Artificial intelligence-based computer-aided polyp detection (CADe) systems are intended to address the issue of missed polyps during colonoscopy. The effect of CADe during screening and surveillance colonoscopy has not previously been studied in a United States (U.S.) population. METHODS: We conducted a prospective, multi-center, single-blind randomized tandem colonoscopy study to evaluate a deep-learning based CADe system (EndoScreener, Shanghai Wision AI, China). Patients were enrolled across 4 U.S. academic medical centers from 2019 through 2020. Patients presenting for colorectal cancer screening or surveillance were randomized to CADe colonoscopy first or high-definition white light (HDWL) colonoscopy first, followed immediately by the other procedure in tandem fashion by the same endoscopist. The primary outcome was adenoma miss rate (AMR), and secondary outcomes included sessile serrated lesion (SSL) miss rate and adenomas per colonoscopy (APC). RESULTS: A total of 232 patients entered the study, with 116 patients randomized to undergo CADe colonoscopy first and 116 patients randomized to undergo HDWL colonoscopy first. After the exclusion of 9 patients, the study cohort included 223 patients. AMR was lower in the CADe-first group compared with the HDWL-first group (20.12% [34/169] vs 31.25% [45/144]; odds ratio [OR], 1.8048; 95% confidence interval [CI], 1.0780-3.0217; P=.0247). SSL miss rate was lower in the CADe-first group (7.14% [1/14]) vs the HDWL-first group (42.11% [8/19]; P=.0482). First-pass APC was higher in the CADe-first group (1.19 [standard deviation (SD), 2.03] vs 0.90 [SD, 1.55]; P=.0323). First-pass ADR was 50.44% in the CADe-first group and 43.64 % in the HDWL-first group (P=.3091). CONCLUSION: In this U.S. multicenter tandem colonoscopy randomized controlled trial, we demonstrate a decrease in AMR and SSL miss rate and an increase in first-pass APC with the use of a CADe-system when compared with HDWL colonoscopy alone.
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