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Computer-assisted colonoscopy identifies more precancerous polyps vs traditional colonoscopy

Wed, 05/25/2022 - 13:11
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Colonoscopies performed with computer-aided detection or artificial intelligence, (AI) saw an increase in the overall rate of detection of adenoma, or cancerous and precancerous polyps, by 27% in average-risk patients, according to new data presented at the Digestive Disease Week Annual Meeting.

The results of the prospective, randomised, multicentre study, led by clinician-scientist, Dr Aasma Shaukat, at NYU Grossman School of Medicine, will be published online in the journal Gastroenterology. The team found that when AI was used during a screening colonoscopy, the adenoma per colonoscopy rate increased significantly by 22%, from .82 to 1.05. This research further suggests that AI can be an efficient tool for gastroenterologists and endoscopists to incorporate into their procedures to reduce the number of polyps missed and left behind in the colon, many of which can be precancerous.

"Our findings add to the growing amount of literature that shows using computer-aided technology during an endoscopy procedure can improve the quality of exams performed and improve outcomes for our patients," explained Shaukat, the Robert M and Mary H Glickman Professor of Medicine and Gastroenterology and Director of Outcomes Research for the Division of Gastroenterology and Hepatology. "Several software technologies are currently available for clinicians and incorporating the use of these resources will only enhance the care we provide our patients and improve the quality of exams we as physicians are able to perform."

Computer-aided detection analyses the colonoscope video feed in real time to identify potential polyps and identify areas of concern on the monitor that the endoscopist can look at in real time, thus improving the results of the procedure.

For the study, 22, skilled, board-certified gastroenterologists performed colonoscopies on 1,440 patients during January 2021—September 2021, who were randomised to receive either a standard colonoscopy or a colonoscopy using computer-aided detection software. All patients included in the study were over the age of 40 and were undergoing a screening or surveillance colonoscopy, but who had not had a previous colonoscopy within the last three years. In total, 677 patients were randomised to the standard arm and 682 into the computer-aided arm. The number of polyps found using a computer-aided colonoscope was 1.05 compared to .82 and there was no decrease in the true histology rate indicating the polyps of concern were all removed.

"Colorectal cancer is the second leading cause of cancer related deaths in the United States and it is one of the few cancers that can be prevented if caught early," added Shaukat. "Our mission remains to improve and enhance the quality and efficacy of the colonoscopy across the board to provide the best care for patients."

The researchers acknowledge that long-term follow up studies are needed to further evaluate the benefit of computer-assisted devices on clinical outcomes.