Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis
Background/Aims Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2022-05-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-228.pdf |
| _version_ | 1797668850915868672 |
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| author | Arun Sivananthan Scarlet Nazarian Lakshmana Ayaru Kinesh Patel Hutan Ashrafian Ara Darzi Nisha Patel |
| author_facet | Arun Sivananthan Scarlet Nazarian Lakshmana Ayaru Kinesh Patel Hutan Ashrafian Ara Darzi Nisha Patel |
| author_sort | Arun Sivananthan |
| collection | DOAJ |
| description | Background/Aims Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling. Results Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07). Conclusions CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies. |
| first_indexed | 2024-03-11T20:35:29Z |
| format | Article |
| id | doaj.art-9ab038ed5451476c957d6940b639b36c |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:35:29Z |
| publishDate | 2022-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-9ab038ed5451476c957d6940b639b36c2023-10-02T06:45:23ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-05-0155335536410.5946/ce.2021.2287624Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysisArun Sivananthan0Scarlet Nazarian1Lakshmana Ayaru2Kinesh Patel3Hutan Ashrafian4Ara Darzi5Nisha Patel6 Institute of Global Health Innovation, Imperial College, London, UK Institute of Global Health Innovation, Imperial College, London, UK Department of Surgery and Cancer, Imperial College NHS Healthcare Trust, London, UK Department of Gastroenterology, Chelsea and Westminster NHS Healthcare Trust, London, UK Institute of Global Health Innovation, Imperial College, London, UK Institute of Global Health Innovation, Imperial College, London, UK Institute of Global Health Innovation, Imperial College, London, UKBackground/Aims Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling. Results Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07). Conclusions CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.http://www.e-ce.org/upload/pdf/ce-2021-228.pdfartificial intelligencecolonoscopycolorectal neoplasmscomputer-aided detection |
| spellingShingle | Arun Sivananthan Scarlet Nazarian Lakshmana Ayaru Kinesh Patel Hutan Ashrafian Ara Darzi Nisha Patel Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis Clinical Endoscopy artificial intelligence colonoscopy colorectal neoplasms computer-aided detection |
| title | Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis |
| title_full | Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis |
| title_fullStr | Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis |
| title_full_unstemmed | Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis |
| title_short | Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis |
| title_sort | does computer aided diagnostic endoscopy improve the detection of commonly missed polyps a meta analysis |
| topic | artificial intelligence colonoscopy colorectal neoplasms computer-aided detection |
| url | http://www.e-ce.org/upload/pdf/ce-2021-228.pdf |
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