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Improvement in adenoma detection rate by artificial intelligence-assisted colonoscopy: Multicenter quasi-randomized controlled trial.

作者信息

Lagström Ronja Maria Birgitta, Bräuner Karoline Bendix, Bielik Julia, Rosen Andreas Weinberger, Crone Julie Gräs, Gögenur Ismail, Bulut Mustafa

机构信息

Department of Surgery, Zealand University Hospital Koge, Køge, Denmark.

Department of Surgery, Slagelse Hospital, Slagelse, Denmark.

出版信息

Endosc Int Open. 2025 Feb 26;13:a25215169. doi: 10.1055/a-2521-5169. eCollection 2025.


DOI:10.1055/a-2521-5169
PMID:40018072
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11866038/
Abstract

BACKGROUND AND STUDY AIMS: Adenoma detection rate (ADR) is a key performance measure with variability among endoscopists. Artificial intelligence (AI) in colonoscopy could reduce this variability and has shown to improve ADR. This study assessed the impact of AI on ADR among Danish endoscopists of varying experience levels. PATIENTS AND METHODS: We conducted a prospective, quasi-randomized, controlled, multicenter trial involving patients aged 18 and older undergoing screening, surveillance, and diagnostic colonoscopy at four centers. Participants were assigned to AI-assisted colonoscopy (GI Genius, Medtronic) or conventional colonoscopy. Endoscopists were classified as experts (> 1000 colonoscopies) or non-experts (≤ 1000 colonoscopies). The primary outcome was ADR. We performed a subgroup analysis stratified on endoscopist experience and a subset analysis of the screening population. RESULTS: A total of 795 patients were analyzed: 400 in the AI group and 395 in the control group. The AI group demonstrated a significantly higher ADR than the control group (59.1% vs. 46.6%, < 0.001). The increase was significant among experts (59.9% vs. 47.3%, < 0.002) but not among non-experts. AI assistance significantly improved ADR (74.4% vs. 58.1%, = 0.003) in screening colonoscopies. Polyp detection rate (PDR) was also higher in the AI group (69.8% vs. 56.2%, < 0.001). There was no significant difference in the non-neoplastic resection rate (NNRR) (15.1% vs. 17.1%, = 0.542). CONCLUSIONS: AI-assisted colonoscopy significantly increased ADR by 12.5% overall, with a notable 16.3% increase in the screening population. The unchanged NNRR indicates that the higher PDR was due to increased ADR, not unnecessary resections.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/091608da9a1b/10-1055-a-2521-5169_25231315.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/c26fb0171777/10-1055-a-2521-5169_25231313.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/ee851a366a5a/10-1055-a-2521-5169_25231314.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/091608da9a1b/10-1055-a-2521-5169_25231315.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/c26fb0171777/10-1055-a-2521-5169_25231313.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/ee851a366a5a/10-1055-a-2521-5169_25231314.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c253/11866038/091608da9a1b/10-1055-a-2521-5169_25231315.jpg

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Improvement in adenoma detection rate by artificial intelligence-assisted colonoscopy: Multicenter quasi-randomized controlled trial.

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本文引用的文献

[1]
How should a cluster randomized trial be analyzed?

J Epidemiol Popul Health. 2024-2

[2]
Linked-color imaging with or without artificial intelligence for adenoma detection: a randomized trial.

Endoscopy. 2024-5

[3]
Prospective study of computer-aided detection of colorectal adenomas in hospitalized patients.

Scand J Gastroenterol. 2023

[4]
Clinical Evaluation of Computer-Aided Colorectal Neoplasia Detection Using a Novel Endoscopic Artificial Intelligence: A Single-Center Randomized Controlled Trial.

Digestion. 2023

[5]
Usefulness of a novel computer-aided detection system for colorectal neoplasia: a randomized controlled trial.

Gastrointest Endosc. 2023-3

[6]
Artificial Intelligence-Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial.

Clin Gastroenterol Hepatol. 2023-2

[7]
Efficacy of a computer-aided detection system in a fecal immunochemical test-based organized colorectal cancer screening program: a randomized controlled trial (AIFIT study).

Endoscopy. 2022-12

[8]
Impact of Artificial Intelligence on Miss Rate of Colorectal Neoplasia.

Gastroenterology. 2022-7

[9]
Effect of an artificial intelligence-based quality improvement system on efficacy of a computer-aided detection system in colonoscopy: a four-group parallel study.

Endoscopy. 2022-8

[10]
Reducing adenoma miss rate of colonoscopy assisted by artificial intelligence: a multicenter randomized controlled trial.

J Gastroenterol. 2021-8

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