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

Kasenee Tiankanon; Satimai Aniwan; Stephen J Kerr; Krittaya Mekritthikrai; Natanong Kongtab; Naruemon Wisedopas; Panida Piyachaturawat; Santi Kulpatcharapong; Sittikorn Linlawan; Poonrada Phromnil; Puth Muangpaisarn; Theerapat Orprayoon; Jaruwan Chanyaswad; Panukorn Sunthornwechapong; Peerapon Vateekul; Pinit Kullavanijaya; Rungsun Rerknimitr

doi:10.1055/a-2210-7999

Endoscopy, Inhaltsverzeichnis

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

Kasenee Tiankanon

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

,

Satimai Aniwan

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

,

Stephen J Kerr

³Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

⁴The Kirby Institute, University of New South Wales, Sydney, Australia

,

Krittaya Mekritthikrai

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

,

Natanong Kongtab

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

,

Naruemon Wisedopas

⁵Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

,

Panida Piyachaturawat

⁶Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand

,

Santi Kulpatcharapong

⁶Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand

,

Sittikorn Linlawan

⁷Department of Medicine, Phrachomklao Hospital, Petchaburi, Thailand (Ringgold ID: RIN90448)

,

Poonrada Phromnil

⁸Department of Medicine, Khlong Khlung Hospital, Kamphaeng Phet, Thailand

,

Puth Muangpaisarn

⁹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)

,

Theerapat Orprayoon

⁹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)

,

Jaruwan Chanyaswad

⁹Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand (Ringgold ID: RIN435268)

,

Panukorn Sunthornwechapong

¹⁰Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

,

Peerapon Vateekul

¹⁰Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

,

Pinit Kullavanijaya

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

,

Rungsun Rerknimitr

¹Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand (Ringgold ID: RIN26683)

²Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

› Institutsangaben

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.

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Referenzen

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