Nakashima H.a· Kitazawa N.a· Fukuyama C.b· Kawachi H.c· Kawahira H.d· Momma K.a· Sakaki N.a

Author affiliations

aDepartment of Gastroenterology, Foundation for Detection of Early Gastric Carcinoma, Tokyo, Japan
bDepartment of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
cDepartment of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
dMedical Simulation Center, Jichi Medical University, Tochigi, Japan

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Article / Publication Details

First-Page Preview

Received: June 07, 2022
Accepted: November 12, 2022
Published online: January 04, 2023

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Introduction: Computer-aided diagnostic systems are emerging in the field of gastrointestinal endoscopy. In this study, we assessed the clinical performance of the computer-aided detection (CADe) of colonic adenomas using a new endoscopic artificial intelligence system. Methods: This was a single-center prospective randomized study including 415 participants allocated into the CADe group (n = 207) and control group (n = 208). All endoscopic examinations were performed by experienced endoscopists. The performance of the CADe was assessed based on the adenoma detection rate (ADR). Additionally, we compared the adenoma miss rate for the rectosigmoid colon (AMRrs) between the groups. Results: The basic demographic and procedural characteristics of the CADe and control groups were as follows: mean age, 54.9 and 55.9 years; male sex, 73.9% and 69.7% of participants; and mean withdrawal time, 411.8 and 399.0 s, respectively. The ADR was 59.4% in the CADe group and 47.6% in the control group (p = 0.018). The AMRrs was 11.9% in the CADe group and 26.0% in the control group (p = 0.037). Conclusion: The colonoscopy with the CADe system yielded an 11.8% higher ADR than that performed by experienced endoscopists alone. Moreover, there was no need to extend the examination time or request the assistance of additional medical staff to achieve this improved effectiveness. We believe that the novel CADe system can lead to considerable advances in colorectal cancer diagnosis.

© 2023 S. Karger AG, Basel

References Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012 Feb 23;366(8):687–96. Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010 May 13;362(19):1795–803. Rex DK. Colonoscopic withdrawal technique is associated with adenoma missrates. Gastrointest Endosc. 2000 Jan;51(1):33–6. Liu A, Wang H, Lin Y, Fu L, Liu Y, Yan S, et al. Gastrointestinal endoscopy nurse assistance during colonoscopy and polyp detection: a PRISMA-compliant meta-analysis of randomized control trials. Medicine. 2020 Aug 21;99(34):e21278. Misawa M, Kudo SE, Mori Y, Maeda Y, Ogawa Y, Ichimasa K, et al. Current status and future perspective on artificial intelligence for lower endoscopy. Dig Endosc. 2021 Jan;33(2):273–84. Weigt J, Repici A, Antonelli G, Afifi A, Kliegis L, Correale L, et al. Performance of a new integrated computer-assisted system (CADe/CADx) for detection and characterization of colorectal neoplasia. Endoscopy. 2022 Feb;54(02):180–4. Sakamoto T, Nakashima H, Nakamura K, Nagahama R, Saito Y. Performance of computer-aided detection and diagnosis of colorectal polyps compares to that of experienced endoscopists. Dig Dis Sci. 2021 Aug 17;67(8):3976–83. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2012;10(1):28–55. FUJIFILM Europe GmbH. ELUXEO Lite Brochure. [cited 2022 August 8]. Available from: https://fujifilm-endoscopy.com/storage/app/media/products/files/ELUXEO%20Lite%20Brochure.pdf. Higurashi T, Ashikari K, Tamura S, Takatsu T, Misawa N, Yoshihara T, et al. Comparison of the diagnostic performance of NBI, Laser-BLI and LED-BLI: a randomized controlled noninferiority trial. Surg Endosc. 2022;36(10):7577–87. Tanaka S, Saitoh Y, Matsuda T, Igarashi M, Matsumoto T, Iwao Y, et al. Evidence-based clinical practice guidelines for management of colorectal polyps. J Gastroenterol. 2021 Apr;56(4):323–35. Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointest Endosc. 2009;69(3):620–5. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003 Dec;58(6 Suppl):S3–43. Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal, appendiceal, and anal carcinoma: the 3d English edition [secondary publication]. J Anus Rectum Colon. 2019;3(4):175–95. Sano Y, Tanaka S, Kudo SE, Saito S, Matsuda T, Wada Y, et al. Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016 Jul;28(5):526–33. Saito Y, Oka S, Kawamura T, Shimoda R, Sekiguchi M, Tamai N, et al. Colonoscopy screening and surveillance guidelines. Dig Endosc. 2021 May;33(4):486–519. Winawer SJ, Zauber AG. The advanced adenoma as the primary target of screening. Gastrointest Endosc Clin North America. 2002;12:1–9. Hassan C, Spadaccini M, Iannone A, Maselli R, Jovani M, Chandrasekar VT, et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc. 2021 Jan;93(1):77–85.e6. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013 Mar;48(3):452–8. Rex DK, Schoenfeld PS, Cohen J, Pike IM, Adler DG, Fennerty BM, et al. Quality indicators for colonoscopy. Am J Gastroenterol. 2015 Jan;110(1):72–90. Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014 Apr 3;370(14):1298–306. Kaminski MF, Wieszczy P, Rupinski M, Wojciechowska U, Didkowska J, Kraszewska E, et al. Increased rate of adenoma detection associates with reduced risk of colorectal cancer and death. Gastroenterology. 2017;153(1):98–105. Floer M, Meister T. Endoscopic improvement of the adenoma detection rate during colonoscopy: where do we stand in 2015? Digestion. 2016;93(3):202–13. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015 Apr;81(4):781–94. Pohl H, Bensen SP, Toor A, Gordon SR, Levy LC, Berk B, et al. Cap-assisted colonoscopy and detection of Adenomatous Polyps (CAP) study: a randomized trial. Endoscopy. 2015 Oct;47(10):891–7. Wu J, Hu B. The role of carbon dioxide insufflation in colonoscopy: a systematic review and meta-analysis. Endoscopy. 2012;44(02):128–36. Yoshida N, Inoue K, Tomita Y, Kobayashi R, Hashimoto H, Sugino S, et al. An analysis about the function of a new artificial intelligence, CAD EYE with the lesion recognition and diagnosis for colorectal polyps in clinical practice. Int J Colorectal Dis. 2021 Oct;36(10):2237–45. Kumar S, Thosani N, Ladabaum U, Friedland S, Chen AM, Kochar R, et al. Adenoma miss rates associated with a 3-minute versus 6-minute colonoscopy withdrawal time: a prospective, randomized trial. Gastrointest Endosc. 2017;85(6):1273–80. Kawamura T, Oda Y, Kobayashi K, Matsuda K, Kida M, Tanaka T, et al. Colonoscopy withdrawal time and adenoma detection rate: a Japanese multicenter analysis. J Gastroenterol Hepatol Res. 2017;6(1):2273–8. Wallace MB, Sharma P, Bhandari P, East J, Antonelli G, Lorenzetti R, et al. Impact of artificial intelligence on miss rate of colorectal neoplasia. Gastroenterology. 2022 Jul;163(1):295–304.e5. Kamba S, Tamai N, Saitoh I, Matsui H, Horiuchi H, Kobayashi M, et al. Reducing adenoma miss rate of colonoscopy assisted by artificial intelligence: a multicenter randomized controlled trial. J Gastroenterol. 2021 Aug;56(8):746–57. Kudo SE, Kouyama Y, Ogawa Y, Ichimasa K, Hamada T, Kato K, et al. Depressed colorectal cancer: a new paradigm in early colorectal cancer. Clin Transl Gastroenterol. 2020 Dec;11(12):e00269. Kudo SE, Misawa M, Mori Y, Hotta K, Ohtsuka K, Ikematsu H, et al. Artificial intelligence-assisted system improves endoscopic identification of colorectal neoplasms. Clin Gastroenterol Hepatol. 2020;18(8):1874–81.e2. Chino A, Yamamoto N, Kato Y, Morishige K, Ishikawa H, Kishihara T, et al. The frequency of early colorectal cancer derived from sessile serrated adenoma/polyps among 1858 serrated polyps from a single institution. Int J Colorectal Dis. 2016;31(2):343–9. Saiki H, Nishida T, Yamamoto M, Hayashi S, Shimakoshi H, Shimoda A, et al. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection. Endosc Int Open. 2016;4(4):E451–8. WHO Classification of Tumours Editorial Board. Digestive system tumours. 5th ed. Geneva: WHO classification of tumours. World Health Organization; 2019. Vol. 8. p. 163–9. Ito R, Ikematsu H, Murano T, Shinmura K, Kojima M, Kumahara K, et al. Diagnostic ability of Japan Narrow-Band Imaging Expert Team classification for colorectal lesions by magnifying endoscopy with blue laser imaging versus narrow-band imaging. Endosc Int Open. 2021 Feb;09(02):E271–7. Article / Publication Details

First-Page Preview

Received: June 07, 2022
Accepted: November 12, 2022
Published online: January 04, 2023

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

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