Spadaccini Marco, Menini Maddalena, Massimi Davide, Rizkala Tommy, De Sire Roberto, Alfarone Ludovico, Capogreco Antonio, Colombo Matteo, Maselli Roberta, Fugazza Alessandro, Brandaleone Luca, Di Martino Antonio, Ramai Daryl, Repici Alessandro, Hassan Cesare
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy.
Department of Gastroneterology, IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, 20089 Milan, Italy.
Cancers (Basel). 2025 Feb 26;17(5):797. doi: 10.3390/cancers17050797.
Colorectal cancer (CRC) prevention depends on effective colonoscopy; yet variability in adenoma detection rates (ADRs) and missed lesions remain significant hurdles. Artificial intelligence-powered computer-aided detection (CADe) systems offer promising advancements in enhancing polyp detection. This review examines the role of CADe in improving ADR and reducing adenoma miss rates (AMRs) while addressing its broader clinical implications. CADe has demonstrated consistent improvements in ADRs and AMRs; largely by detecting diminutive polyps, but shows limited efficacy in identifying advanced adenomas or sessile serrated lesions. Challenges such as operator deskilling and the need for enhanced algorithms persist. Combining CADe with adjunctive techniques has shown potential for further optimizing performance. While CADe has standardized detection quality; its long-term impact on CRC incidence and mortality remains inconclusive. Future research should focus on refining CADe technology and assessing its effectiveness in reducing the global burden of CRC.
结直肠癌（CRC）的预防依赖于有效的结肠镜检查；然而，腺瘤检出率（ADR）的变异性和漏诊病变仍然是重大障碍。人工智能驱动的计算机辅助检测（CADe）系统在增强息肉检测方面提供了有前景的进展。本综述探讨了CADe在提高ADR和降低腺瘤漏诊率（AMR）方面的作用，同时探讨其更广泛的临床意义。CADe已证明在ADR和AMR方面有持续改善；主要是通过检测微小息肉，但在识别高级别腺瘤或无蒂锯齿状病变方面疗效有限。诸如操作人员技能退化和算法需要改进等挑战依然存在。将CADe与辅助技术相结合已显示出进一步优化性能的潜力。虽然CADe使检测质量标准化，但其对CRC发病率和死亡率的长期影响仍无定论。未来的研究应侧重于改进CADe技术，并评估其在减轻全球CRC负担方面的有效性。
