Real-time colorectal polyp detection using a novel computer-aided detection system (CADe): a feasibility study

E Soons; T Rath; Y Hazewinkel; W A van Dop; D Esposito; P A Testoni; P D Siersema

doi:10.1007/s00384-022-04258-9

Real-time colorectal polyp detection using a novel computer-aided detection system (CADe): a feasibility study

Int J Colorectal Dis. 2022 Oct;37(10):2219-2228. doi: 10.1007/s00384-022-04258-9. Epub 2022 Sep 27.

Authors

E Soons¹, T Rath², Y Hazewinkel³, W A van Dop³, D Esposito⁴, P A Testoni⁴, P D Siersema³

Affiliations

¹ Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Center, 9101, 6500 HB, Nijmegen, the Netherlands. elsa.soons@radboudumc.nl.
² Department of Internal Medicine 1, Division of Gastroenterology, Friedrich-Alexander-University, Ludwig Demling Endoscopy Center of Excellence, Erlangen Nuernberg, Germany.
³ Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Center, 9101, 6500 HB, Nijmegen, the Netherlands.
⁴ Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy.

Abstract

Background and aims: Colonoscopy aims to early detect and remove precancerous colorectal polyps, thereby preventing development of colorectal cancer (CRC). Recently, computer-aided detection (CADe) systems have been developed to assist endoscopists in polyp detection during colonoscopy. The aim of this study was to investigate feasibility and safety of a novel CADe system during real-time colonoscopy in three European tertiary referral centers.

Methods: Ninety patients undergoing colonoscopy assisted by a real-time CADe system (DISCOVERY; Pentax Medical, Tokyo, Japan) were prospectively included. The CADe system was turned on only at withdrawal, and its output was displayed on secondary monitor. To study feasibility, inspection time, polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion (SSL) detection rate (SDR), and the number of false positives were recorded. To study safety, (severe) adverse events ((S)AEs) were collected. Additionally, user friendliness was rated from 1 (worst) to 10 (best) by endoscopists.

Results: Mean inspection time was 10.8 ± 4.3 min, while PDR was 55.6%, ADR 28.9%, and SDR 11.1%. The CADe system users estimated that < 20 false positives occurred in 81 colonoscopy procedures (90%). No (S)AEs related to the CADe system were observed during the 30-day follow-up period. User friendliness was rated as good, with a median score of 8/10.

Conclusion: Colonoscopy with this novel CADe system in a real-time setting was feasible and safe. Although PDR and SDR were high compared to previous studies with other CADe systems, future randomized controlled trials are needed to confirm these detection rates. The high SDR is of particular interest since interval CRC has been suggested to develop frequently through the serrated neoplasia pathway.

Clinical trial registration: The study was registered in the Dutch Trial Register (reference number: NL8788).

Keywords: Colorectal adenoma; Colorectal polyp; Computer-aided detection (CADe) system; Detection; Endoscopy.

MeSH terms

Adenoma* / diagnosis
Colonic Polyps* / diagnostic imaging
Colonic Polyps* / pathology
Colonoscopy / methods
Colorectal Neoplasms* / diagnosis
Colorectal Neoplasms* / pathology
Computers
Feasibility Studies
Humans
Juniperus*