Automated polyp detection in the colorectum: a prospective study (with videos)

Gastrointest Endosc. 2019 Mar;89(3):576-582.e1. doi: 10.1016/j.gie.2018.09.042. Epub 2018 Oct 17.


Background and aims: Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions.

Methods: This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard.

Results: The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS.

Conclusion: Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).

Publication types

  • Observational Study
  • Video-Audio Media

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / pathology
  • Adenomatous Polyps / diagnosis*
  • Adenomatous Polyps / pathology
  • Aged
  • Automation
  • Carcinoma / diagnosis*
  • Carcinoma / pathology
  • Cohort Studies
  • Colonic Polyps / diagnosis*
  • Colonic Polyps / pathology
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / pathology
  • Female
  • Humans
  • Image Processing, Computer-Assisted*
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Software*
  • Tumor Burden

Associated data