Endoscopy 2024; 56(04): 273-282
DOI: 10.1055/a-2210-7999
Original article

Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: a randomized multicenter trial

1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Satimai Aniwan
1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Stephen J Kerr
3   Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
4   The Kirby Institute, University of New South Wales, Sydney, Australia
,
Krittaya Mekritthikrai
1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Natanong Kongtab
1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Naruemon Wisedopas
5   Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
,
Panida Piyachaturawat
6   Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand
,
Santi Kulpatcharapong
6   Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand
,
Sittikorn Linlawan
7   Department of Medicine, Phrachomklao Hospital, Petchaburi, Thailand (Ringgold ID: RIN90448)
,
Poonrada Phromnil
8   Department of Medicine, Khlong Khlung Hospital, Kamphaeng Phet, Thailand
,
Puth Muangpaisarn
9   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)
,
Theerapat Orprayoon
9   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)
,
Jaruwan Chanyaswad
9   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)
,
Panukorn Sunthornwechapong
10   Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
,
Peerapon Vateekul
10   Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
,
Pinit Kullavanijaya
1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
1   Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)
2   Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
› Author Affiliations
Supported by: Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University RA65_CRC_003
Supported by: the National Research Council of Thailand (NRCT) N42A640330
Center of Excellence for Gastrointestinal and Oncology Endoscopy unit, King Chulalongkorn Memorial Hospital

Clinical Trial: Registration number (trial ID): TCTR20230706006, Trial registry: Thai Clinical Trials Registry (https://www.clinicaltrials.in.th/), Type of Study: Prospective, Randomized, Multi-Center Study


Abstract

Background This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control.

Methods Average-risk 50–75-year-old individuals who underwent screening colonoscopy at five referral centers were randomized to SD-CADe, CM-CADe, or WLE groups (1:1:1 ratio). Trainees and staff with an adenoma detection rate (ADR) of ≥35% were recruited. The primary outcome was ADR. Secondary outcomes were the proximal adenoma detection rate (pADR), advanced adenoma detection rate (AADR), and the number of adenomas, proximal adenomas, and advanced adenomas per colonoscopy (APC, pAPC, and AAPC, respectively).

Results The study enrolled 1200 participants. The ADR in the control, CM-CADe, and SD-CADe groups was 38.3%, 50.0%, and 54.8%, respectively. The pADR was 23.0%, 32.3%, and 38.8%, respectively. AADR was 6.0%, 10.3%, and 9.5%, respectively. After adjustment, the ADR and pADR in both intervention groups were significantly higher than in controls (all P<0.05). The APC in the control, CM-CADe, and SD-CADe groups was 0.66, 1.04, and 1.16, respectively. The pAPC was 0.33, 0.53, and 0.64, respectively, and the AAPC was 0.07, 0.12, and 0.10, respectively. Both CADe systems showed significantly higher APC and pAPC than WLE. AADR and AAPC were improved in both CADe groups versus control, although the differences were not statistically significant.

Conclusion Even in high adenoma detectors, CADe significantly improved ADR and APC. The AADR tended to be higher with both systems, and this may enhance colorectal cancer prevention.

Supplementary Material



Publication History

Received: 03 September 2023

Accepted after revision: 14 November 2023

Accepted Manuscript online:
14 November 2023

Article published online:
21 December 2023

© 2023. Thieme. All rights reserved.

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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