Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy.
Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(11):1089-1099. doi: 10.1080/17474124.2023.2273990. Epub 2023 Nov 23.
The introduction of widespread colonoscopy screening programs has helped in decreasing the incidence of Colorectal Cancer (CRC). However, 'back-to-back' colonoscopies revealed relevant percentage of missed adenomas. Quality indicators were created to further homogenize detection performances and decrease the incidence of post-colonoscopy CRC. Among them, the Adenoma Detection Rate (ADR), defined as the percentage obtained by dividing the number of endoscopic procedures in which at least one adenoma was resected, by the total number of procedures, was found to be inversely associated with the risks of interval colorectal cancer, advanced-stage interval cancer, and fatal interval cancer.
In this paper, we performed a comprehensive review of the literature focusing on promising new devices and technologies, which are meant to positively affect the endoscopist performance in detecting adenomas, therefore increasing ADR.
Considering the current knowledge, although several devices and technologies have been proposed with this intent, the recent implementation of AI ranked over all of the other strategies and it is likely to become the new standard within few years. However, the combination of different device/technologies need to be investigated in the future aiming at even further increasing of endoscopist detection performances.
广泛开展结肠镜筛查计划有助于降低结直肠癌（CRC）的发病率。然而，“背靠背”结肠镜检查显示出相关的腺瘤漏诊率。质量指标的创建进一步统一了检测性能，降低了结肠镜检查后的 CRC 发生率。其中，腺瘤检出率（ADR）定义为切除的腺瘤内镜检查次数与总检查次数的比值，与结直肠间期癌、晚期间期癌和致命间期癌的风险呈负相关。
本文对文献进行了全面回顾，重点关注有前途的新设备和技术，这些设备和技术旨在积极影响内镜医师检测腺瘤的能力，从而提高 ADR。
鉴于目前的知识，尽管已经提出了几种旨在提高腺瘤检出率的设备和技术，但最近人工智能的应用超过了所有其他策略，并且可能在几年内成为新标准。然而，未来需要研究不同设备/技术的组合，以进一步提高内镜医师的检测性能。
