Takasu Ayaka, Kogure Hirofumi, Dai Zhehao, Yamada Yuki, Nakayama Masako, Bechara Robert, Gotoda Takuji, Miura Yoshimasa
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
J Gastroenterol Hepatol. 2025 Sep;40(9):2258-2266. doi: 10.1111/jgh.17040. Epub 2025 Jul 1.
Computer-aided detection (CAD) can improve adenoma detection rates (ADRs); however, the impact of its introduction into real-world practice remains unclear. This study investigated the effect of CAD's introduction on colonoscopy in a hospital.
This retrospective study included 1314 patients who underwent colonoscopy between January and December 2023 at a single facility where CAD was introduced in three of four endoscopy rooms. ADR, polyp detection rate (PDR), and sessile serrated lesion detection rate (SSLDR) were first compared between patients who underwent colonoscopy without CAD before introduction to the facility (pre-intervention non-CAD group) and those who underwent colonoscopy with CAD after introduction (CAD group). Subsequently, cases without CAD were analyzed to evaluate endoscopists' performance by comparing the detection rates between the pre-intervention non-CAD group and patients who underwent colonoscopy without CAD after introduction (post-intervention non-CAD group).
ADR (49.3% vs. 31.6%, p < 0.001) and PDR (57.9% vs. 39.8%, p < 0.001) were significantly higher in the CAD group than in the pre-intervention non-CAD group; SSLDR (4.4% vs. 2.8%, p = 0.14) was comparable between groups. ADR (31.6% vs. 13.5%, p < 0.001) and PDR (39.8% vs. 18.2%, p < 0.001) were significantly lower in the post-intervention non-CAD group than in the pre-intervention non-CAD group.
The introduction of CAD-assisted colonoscopy significantly improved ADR and PDR. However, CAD reliance may lead to lapses in attention toward independent lesion detection by endoscopists. It is essential to consider how CAD should be utilized in clinical practice to maximize its benefits.
计算机辅助检测（CAD）可提高腺瘤检出率（ADR）；然而，将其引入实际临床实践的影响尚不清楚。本研究调查了在一家医院中引入CAD对结肠镜检查的影响。
本回顾性研究纳入了2023年1月至12月在一家单一机构接受结肠镜检查的1314例患者，该机构的四个内镜检查室中有三个引入了CAD。首先比较了在该机构引入CAD之前接受无CAD结肠镜检查的患者（干预前非CAD组）和引入CAD后接受有CAD结肠镜检查的患者（CAD组）之间的ADR、息肉检出率（PDR）和无蒂锯齿状病变检出率（SSLDR）。随后，分析无CAD的病例，通过比较干预前非CAD组和引入后接受无CAD结肠镜检查的患者（干预后非CAD组）之间的检出率来评估内镜医师的表现。
CAD组的ADR（49.3%对31.6%，p<0.001）和PDR（57.9%对39.8%，p<0.001）显著高于干预前非CAD组；两组间SSLDR（4.4%对2.8%，p=0.14）相当。干预后非CAD组的ADR（31.6%对13.5%，p<0.001）和PDR（39.8%对18.2%，p<0.001）显著低于干预前非CAD组。
引入CAD辅助结肠镜检查显著提高了ADR和PDR。然而，对CAD的依赖可能导致内镜医师对独立病变检测的注意力下降。必须考虑如何在临床实践中利用CAD以使其益处最大化。
