Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: a randomized multicenter trial.

Autor:	Tiankanon K; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Aniwan S; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Kerr SJ; Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.; The Kirby Institute, University of New South Wales, Sydney, Australia., Mekritthikrai K; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Kongtab N; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Wisedopas N; Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand., Piyachaturawat P; Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand., Kulpatcharapong S; Gastrointestinal and Liver Center, MedPark Hospital, Bangkok, Thailand., Linlawan S; Department of Medicine, Phrachomklao Hospital, Petchaburi, Thailand., Phromnil P; Department of Medicine, Khlong Khlung Hospital, Kamphaeng Phet, Thailand., Muangpaisarn P; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand., Orprayoon T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand., Chanyaswad J; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Prapokklao Hospital, Chanthaburi, Thailand., Sunthornwechapong P; Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand., Vateekul P; Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand., Kullavanijaya P; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand., Rerknimitr R; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Gastrointestinal Endoscopy Excellence Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2024 Apr; Vol. 56 (4), pp. 273-282. Date of Electronic Publication: 2023 Nov 14.
DOI:	10.1055/a-2210-7999
Abstrakt:	Background: This study aimed to evaluate the benefits of a self-developed computer-aided polyp detection system (SD-CADe) and a commercial system (CM-CADe) for high adenoma detectors compared with white-light endoscopy (WLE) as a control. Methods: Average-risk 50-75-year-old individuals who underwent screening colonoscopy at five referral centers were randomized to SD-CADe, CM-CADe, or WLE groups (1:1:1 ratio). Trainees and staff with an adenoma detection rate (ADR) of ≥35% were recruited. The primary outcome was ADR. Secondary outcomes were the proximal adenoma detection rate (pADR), advanced adenoma detection rate (AADR), and the number of adenomas, proximal adenomas, and advanced adenomas per colonoscopy (APC, pAPC, and AAPC, respectively). Results: The study enrolled 1200 participants. The ADR in the control, CM-CADe, and SD-CADe groups was 38.3%, 50.0%, and 54.8%, respectively. The pADR was 23.0%, 32.3%, and 38.8%, respectively. AADR was 6.0%, 10.3%, and 9.5%, respectively. After adjustment, the ADR and pADR in both intervention groups were significantly higher than in controls (all P<0.05). The APC in the control, CM-CADe, and SD-CADe groups was 0.66, 1.04, and 1.16, respectively. The pAPC was 0.33, 0.53, and 0.64, respectively, and the AAPC was 0.07, 0.12, and 0.10, respectively. Both CADe systems showed significantly higher APC and pAPC than WLE. AADR and AAPC were improved in both CADe groups versus control, although the differences were not statistically significant. Conclusion: Even in high adenoma detectors, CADe significantly improved ADR and APC. The AADR tended to be higher with both systems, and this may enhance colorectal cancer prevention. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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