Combining CADe and a Mucosal Exposure Device Provides Best Detection During Colonoscopy

Combining CADe and a Mucosal Exposure Device Provides Best Detection During Colonoscopy

Douglas K. Rex, MD, MASGE, reviewing Aniwan S, et al. Gastrointest Endosc 2022 Oct 8.

In a randomized controlled trial, 1245 participants aged 50 to 75 years were randomized to standard colonoscopy, standard colonoscopy plus an artificial intelligence (AI) detection program (CADe), standard colonoscopy with Endocuff (Olympus Corp, Tokyo, Japan) assistance (EAC), or CADe plus EAC. The adenoma detection rates (ADRs) in the control, CADe, EAC, and CADe plus EAC groups were 41.9%, 52.2%, 54%, and 58.8%, respectively. Adenomas per colonoscopy in the 4 respective groups were 0.76, 1.11, 1.18, and 1.31. The advanced ADRs (AADRs) for the 4 groups were 7.7%, 8.3%, 8.3%, and 13.6%, respectively. Only the group with the combination of CADe plus EAC had improved AADR compared with controls.

Douglas K. Rex, MD, FASGE

COMMENT

This important study indicates that for colonoscopists to optimize detection, they need both a CADe program and a mucosal exposure device. This appears to be the current state-of-the-art for detection. It will be interesting to see whether mucosal exposure devices still improve detection when AI for the quality of mucosal evaluation (computer-aided quality assessment programs) becomes available.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Aniwan S, Mekritthikrai K, Kerr SJ, et al. Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: a randomized controlled trial. Gastrointest Endosc 2022 Oct 8. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2022.09.023)

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