Computer aid improves adenoma detection during colonoscopy

The use of a computer-aided detection (CADe) device helps increase the overall rate of adenoma detection during screening and surveillance colonoscopy, reports a new study. Such benefit was apparent even for experienced endoscopists.

Researchers conducted a randomized prospective study of 1,359 adults who were undergoing scheduled surveillance or screening colonoscopy. A total of 682 were assigned to the CADe arm, while the remaining 677 were allocated to the standard control arm. Endoscopies were performed by 22 board-certified gastroenterologists enrolled across five academic and community centres.

Adenomas per colonoscopy, one of the primary outcomes, was significantly higher in the CADe vs standard arm (1.04 vs 0.83; p=0.002). Similarly, the number of adenomas detected was much higher with the CADe device, which found a total of 719 adenomas, as opposed to only 562 in the unaided procedure.

Meanwhile, the adenoma detection rate was only marginally better in the CADe arm (47.8 percent vs 43.9 percent; p=0.065).

Of note, the better adenoma detection with CADe did not significantly weaken the true histology rate (THR) in this arm vs standard endoscopy (67.4 percent vs 71.7 percent; p<0.001 for noninferiority).

These findings suggest that for “high-volume endoscopists performing screening and surveillance colonoscopies in the United States, this novel CADe device improved APC, an important quality indicator for colonoscopy that is of relevance to endoscopists, without decreasing THR,” according to the researchers.