Disclosures: Wang reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
June 19, 2020
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Computer-aided colonoscopy reduces adenoma miss rate

Disclosures: Wang reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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A computer-aided system helped reduce the number of missed adenomas and missed polyps during colonoscopy, according to study results.

Pu Wang, MD, of Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospitals in China, and colleagues wrote that despite modern technology and cleansing techniques, nonvisualization of adenoma remains a significant problem, and a computer-aided detection (CADe) system may improve diagnostic capabilities.

“While past prospective studies have shown a clear increase in [adenoma detection rate], relatively little is known in regards to the exact contribution of the CADe system to the increase in detection rate,” they wrote. “In addition, [adenoma missed rate], another important indicator that reflect the quality of colonoscopy, has not been specifically examined. Such a variable can directly reflect the impact of CADe by using a back-to-back comparison.”

Researchers performed a prospective study in 369 patients referred for diagnostic or surveillance colonoscopies. Patients underwent CADe colonoscopy or routine colonoscopy first followed by the other procedure on the same day by the same endoscopist.

The primary outcome of the study was adenoma missed rate (AMR), defined as the number of adenomas detected in the second-pass colonoscopy divided by the total number of adenomas detected in both passes.

Wang and colleagues found that the AMR was lower with CADe (13.89%; 95% CI,

8.24-19.54) compared with routine colonoscopy (40%; 95% CI, 31.23-48.77). CADe also had a lower polyp miss rate (12.98%; 95% CI, 9.08-16.88) compared with routine colonoscopy (45.9%; 95% CI, 39.65-52.15).

Additionally, investigators found that the AMR in the ascending, transverse and descending colon were lower with CADe compared with routine colonoscopy (6.67% vs. 39.13%; 16.33% vs. 45.16%; 12.5% vs. 40.91%, respectively).

“The results from this study suggest a significantly lower AMR when utilizing a CADe

technology when compared to routine white light colonoscopy,” Wang and colleagues wrote. “The detection of diminutive and small adenomas with non-advanced histology and non-pedunculated shape could be effectively improved by CADe colonoscopy. The CADe colonoscopy has the potential to be improve the clinical efficacy of screening and surveillance colonoscopy.”