Polyp Detection Rate Research Articles

Additional 30-Second Observation of the Right-Sided Colon for Missed Polyp Detection With Texture and Color Enhancement Imaging Compared with Narrow Band Imaging: A Randomized Trial.

The efficacy of texture and color enhancement imaging (TXI) in the novel light-emitting diode endoscopic system for polyp detection has not been examined. We aimed to evaluate the noninferiority of the additional 30-second (Add-30-s) observation of the right-sided colon (cecum/ascending colon) with TXI compared with narrow band imaging (NBI) for detecting missed polyps. We enrolled 381 patients ≥40 years old who underwent colonoscopy from September 2021 to June 2022 in 3 institutions and randomly assigned them to either the TXI or NBI groups. The right-sided colon was first observed with white light imaging in both groups. Second, after reinsertion from hepatic flexure to the cecum, the right-sided colon was observed with Add-30-s observation of either TXI or NBI. The primary endpoint was to examine the noninferiority of TXI to NBI using the mean number of adenomas and sessile serrated lesions per patient. The secondary ones were to examine adenoma detection rate, adenoma and sessile serrated lesions detection rates, and polyp detection rates in both groups. The TXI and NBI groups consisted of 177 and 181 patients, respectively, and the noninferiorities of the mean number of adenomas and sessile serrated lesions per patients in the second observation were significant (TXI 0.29 [51/177] vs NBI 0.30 [54/181], P < 0.01). The change in adenoma detection rate, adenoma and sessile serrated lesions detection rate, and polyp detection rate for the right-sided colon between the TXI and NBI groups were not different (10.2%/10.5% [ P = 0.81], 13.0%/12.7% [ P = 0.71], and 15.3%/13.8% [ P = 0.71]), respectively. Regarding Add-30-s observation of the right-sided colon, TXI was noninferior to NBI.

S255 G-EYE Improves Polyp and Adenoma Detection Rates in Colonoscopy: A Systematic Review and Meta-Analysis

S255 G-EYE Improves Polyp and Adenoma Detection Rates in Colonoscopy: A Systematic Review and Meta-Analysis

Advancing Colorectal Cancer Screening: A Comprehensive Systematic Review of Artificial Intelligence (AI)-Assisted Versus Routine Colonoscopy.

Colorectal cancer (CRC) is a rapidly escalating public health concern, which underlines the significance of its early detection and the need for the refinement of current screening methods. In this systematic review, we aimed to analyze the potential advantages and limitations of artificial intelligence(AI)-based computer-aided detection (CADe) systems as compared to routine colonoscopy. This review beginsby shedding light on the global prevalence and mortality rates of CRC, highlighting the urgent need for effective screening techniques and early detection of this cancer type. It addresses the problems associated with undetected adenomas and polyps and the subsequent risk of interval CRC following colonoscopy. The incorporation of AI into diagnostics has been studied, specifically the use of CADe systems which are powered by deep learning. The review summarizes the findings from 13 randomized controlled trials (RCTs) (2019-2023), evaluating the impact of CADe on polyp and adenoma detection. The findings from the studies consistently show that CADe is superior toconventional colonoscopy procedures in terms of adenoma detection rate (ADR)and polyp detection rate(PDR), particularly with regard to small and flat lesions which are easily overlooked. The review acknowledges certain limitations of the included studies, such as potential performance bias and geographic limitations. The review ultimately concludes that AI-assisted colonoscopy can reduce missed lesion rates and improve CRC diagnosis. Collaboration between experts and clinicians is key for successful implementation. In summary, this review analyzes recent RCTson AI-assisted colonoscopy for polyp and adenoma detection. It describes the likely benefits, limitations, and futureimplications of AI in enhancing colonoscopy procedures and lowering the incidence of CRC. More double-blinded trials and studies among diverse populations from different countries must be conducted to substantiate and expand upon the findings of this review.

Colorectal adenomatous and serrated polyps in rural South Australia: who, why, what and where?

The adenoma-carcinoma and serrated pathways offer a window of opportunity for the removal of pre-malignant polyps and prevention of colorectal cancer (CRC) through the use of colonoscopy. The aim of this study was to investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located. This study is based on the colonoscopy data collected prospectively over a one-year period in multiple South Australian rural centres, 24 general surgeons contributed to this study. All histopathology results were subsequently entered into the dataset. A total of 3497 colonoscopies were performed, with a total of 2221 adenomatous and serrated polyps removed. Both serrated and adenomatous polyps were more common in the distal colon. Patients of male gender, aged 70 years and over and with an indication of polyp surveillance had higher adenoma and serrated polyp detection rates (ADR and SPDR). Patients aged 40-49 years old who underwent colonoscopy for positive faecal occult blood had an ADR and SPDR of 25.0% and 6.3%, respectively. This study has shown variation in ADR and SPDR depending on age, gender and indication for colonoscopy. This variation will help further develop key performance indicators in colonoscopy. The high ADR and SPDR in patients aged 40-49 years old whom underwent colonoscopy for positive faecal occult blood may support lowering the age of commencement of CRC screening in Australia.

You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy.

Participation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes. This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random-effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias. Seventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR=1.26, 95% CI=1.14-1.40, p<0.001; OR=1.29, 95% CI=1.02-1.63, p=0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD=0.12, 95% CI=0.08-0.17, p<0.001; MD=0.15, 95% CI=0.02-0.28, p=0.020, respectively). In addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.

Measuring the observer (Hawthorne) effect on adenoma detection rates.

Background and study aims An independent observer can improve procedural quality. We evaluated the impact of the observer (Hawthorne effect) on important quality metrics during colonoscopies. Patients and Methods In a single-center comparative study, consecutive patients undergoing routine screening or diagnostic colonoscopy were prospectively enrolled. In the index group, all procedural steps and quality metrics were observed and documented, and the procedure was video recorded by an independent research assistant. In the reference group, colonoscopies were performed without independent observation. Colonoscopy quality metrics such as polyp, adenoma, serrated lesions, and advanced adenoma detection rates (PDR, ADR, SLDR, AADR) were compared. The probabilities of increased quality metrics were evaluated through regression analyses weighted by the inversed probability of observation during the procedure. Results We included 327 index individuals and 360 referents in the final analyses. The index group had significantly higher PDRs (62.4% vs. 53.1%, P =0.02) and ADRs (39.4% vs. 28.3%, P =0.002) compared with the reference group. The SLDR and AADR were not significantly increased. After adjusting for potential confounders, the ADR and SLDR were 50% (relative risk [RR] 1.51; 95%, CI 1.05-2.17) and more than twofold (RR 2.17; 95%, CI 1.05-4.47) more likely to be higher in the index group than in the reference group. Conclusions The presence of an independent observer documenting colonoscopy quality metrics and video recording the colonoscopy resulted in a significant increase in ADR and other quality metrics. The Hawthorne effect should be considered an alternative strategy to advanced devices to improve colonoscopy quality in practice.

Bowel preparation efficacy and safety of compound polyethylene glycol electrolyte powder combined with linaclotide for colonoscopy: A randomized controlled trial.

Adequate bowel preparation is essential for colonoscopy, which is important for detecting colon polyps and preventing colorectal cancer. Linaclotide is approved for irritable bowel syndrome with predominant constipation (IBS-C) symptoms. The main objective of this study was to explore the quality of bowel preparation by low-volume compound polyethylene glycol (PEG) combined with linaclotide. A total of 266 patients who underwent colonoscopy in Shangrao People's Hospital from June 2021 to June 2022 were randomized to 1 of 3 split PEG regimens: 4LPEG, 2LPEG, and 2LPEG + L (linaclotide). The primary end point was adequate bowel preparation (Boston Bowel Preparation Scale [BBPS] total score of ≥6, with each of three colonic segments subscores ≥2). Secondary outcomes were polyp detection rates and the incidence of adverse reactions. Over 12 months, 266 subjects were randomized into 2LPEG (n = 12), 4LPEG (n = 112), or 2LPEG + L (n = 142). There were no significant differences between the 4LPEG and 2LPEG + L groups in achieving adequate bowel preparation (P > 0.05). The mean BBPS score of the total colon, left hemi-colon, right hemi-colon, and transverse in the 2LPEG + L group was higher than that in the 2LPEG group (P < 0.001). Patient's sleeping quality and the incidence of adverse reactions of 2LPEG + L group were compatible with 2LPEG group, but it was significantly lower than that in 4LPEG group. There was no statistically significant difference in the detection rate of colon polyps between each group. The quality of bowel preparation of the compound polyethylene glycol electrolyte powder combined with linaclotide is approximately the same as that of 4LPEG, and it can reduce the adverse reactions in the process of bowel preparation, and its intestinal cleansing effect is also better than that of 2LPEG.

G-EYE Colonoscopy Is Superior to Standard Colonoscopy for Increasing Adenoma/Polyp Detection Rate

Abstract Background Colorectal cancer (CRC) is one of the most common cancers worldwide. Most CRCs develop from malignant potential polyps, especially adenomas, SSPs and SSLs. Screening is associated with a reduction in CRC incidence through the detection and removal of precancerous polyps and with reduction in CRC related death through reduction of the incidence and early detection of CRC. Colonoscopy is the most widely used screening tool. Unfortunately during colonoscopy examinations, a substantial number of polyps are still being missed. These missed polyps though to be at least 50% of interval CRCs. Objective comparison between G-EYE colonoscopy and standard colonoscopy (SC) for increasing adenoma/polyp detection rate. Patients and Methods prospective randomized study was conducted on 80 Patients as one group, selection done at Hepatology and Gastroenterology department in Theodor Bilharz Research Institute and Outpatient clinic of Gastroenterology unit at Ain Shams University Hospitals. From: June 2021 to November 2021, after ethical committee approval. Results prospective randomized study demonstrated that the polyp detection rate (PDR) was an increased rate by G-EYE colonoscopy, this difference was statistically significant (P ≤ 0.05) as the total number of patients having polyps detected by G-EYE was 28 (40.60%) and the total number of polyps was 43 polyps while by SC was 15 (21.70%) and the total number of polyps was 19 polyps. There is an advantage for G-EYE over SC in relation to the size of the detected polyps as this study compared the detected polyp size as diminutive (&amp;lt;5 mm), small (6-9 mm) and large polyps (&amp;gt;10 mm) by G-EYE versus SC. For the diminutive polyps, the difference was statistically significant (P ≤ 0.05) favoring the G-EYE, and for small polyps the G-EYE was superior to SC by 3 polyps, while for large polyps there was no difference. G-EYE increased the ADR in comparison with SC [22 (100%) vs 9 (13%) ] respectively as G-EYE colonoscopy detected an additional 15 adenomatous polyps in 13 patients missed from SC colonoscopy. The difference was statistically significant. Fortunately there were very few complications, abdominal pain reported in 3 cases after the end of procedures. Conclusion The study demonstrated that G-EYE is superior to SC in increasing adenoma and polyp detection rate as being more rapid and more precise for detection of diminutive and small adenomatous polyps. However G-EYE could not be done in certain conditions such as diverticulosis, masses, ulcerations or colonic strictures for fear of perforation or incomplete intubation, in this study those patients were excluded from the start as the aim of the study was polyp detection rate difference by balloon assisted colonoscopy (G-EYE) in comparison to the standard colonoscopy (SC).

Clinical value of sigmoid colon water exchange colonoscopy: a prospective randomized clinical trial

This prospective randomized controlled trial investigated the clinical value of sigmoid colon water exchange (SWE) colonoscopy by comparing it with air insufflation (AI) colonoscopy in terms of the patient’s pain score, insertion time, and screening quality. Consecutive patients who underwent colonoscopy without sedation were randomized into an AI group (n = 267) or an SWE group (n = 255). Patient characteristics, history of abdominal or pelvic surgery, maximum pain score, insertion time, cecal intubation rate, polyp detection rate, and the need for maneuvers were recorded. There was no significant between-group difference in insertion time, cecal intubation rate, assisted maneuvers (abdominal pressure, changing patients’ position), or polyp detection rate (P > 0.05). The mean maximum pain score was significantly lower in the SWE group than in the AI group. (3.57 ± 2.01 vs. 4.69 ± 1.83, P < 0.001). For patients with a history of abdominal or pelvic surgery and those who were overweight (body mass index > 24), the maximum pain scores were lower in the SWE group than in the AI group (3.67 ± 1.95 vs. 4.88 ± 1.80, P < 0.001; 3.40 ± 1.96 vs. 4.79 ± 1.97, P < 0.001, respectively). SWE colonoscopy can significantly reduce abdominal pain with non-inferior screening quality and does not increase insertion time.Trial registration number: ChiCTR2200059057 (date April 23, 2022).

Clinical and endoscopic characteristics and management of 220 cases with serrated polyps

BackgroundSerrated polyps are considered the precursor lesions of colorectal cancer through the serrated pathway. In the present study, we aimed to evaluate and discuss the clinical and endoscopic characteristics and management of serrated polyps. MethodsThe data of 220 cases with serrated polyps between September 2018 and November 2021 in Shenzhen People's Hospital were retrospectively analyzed. ResultsOf all these cases, 32 were hyperplastic polyps, 36 were traditional serrated adenomas, 126 were sessile serrated lesions, 25 were SSLs with dysplasia, and one was an unclassified serrated adenoma. Although most patients were males aged ≥50 years and most serrated polyps were located in the distal colon and rectum with a size of 6–10 mm and the shape of type 0-Is, there was no significant difference (P > 0.05). Serrated polyps of ≤5 mm in size and type 0-IIa were mostly removed by cold biopsy forceps. Cold snare polypectomy was primarily used for those of 6–10 mm in size. Endoscopic mucosal resection was used for those of 6–20 mm, and endoscopic submucosal dissection was used for those of ≥20 mm (P < 0.05). All complications occurred in SSL patients with or without dysplasia (P < 0.05). ConclusionsClinical and endoscopic characteristics were beneficial for distinguishing and diagnosing serrated polyps. In addition, management options were crucial to prevent recurrence and progression. However, the detection rate of serrated polyps was relatively low. Therefore, prospective multicenter studies with large samples are necessary to better assess colorectal serrated polyps.

Colorectal polyp outcomes after participation in the seAFOod polyp prevention trial: Evidence of rebound elevated colorectal polyp risk after short-term aspirin use.

The seAFOod polyp prevention trial was a randomised, placebo-controlled, 2 × 2 factorial trial of aspirin 300 mg and eicosapentaenoic acid (EPA) 2000 mg daily in individuals who had a screening colonoscopy in the English Bowel Cancer Screening Programme (BCSP). Aspirin treatment was associated with a 20% reduction in colorectal polyp number at BCSP surveillance colonoscopy 12 months later. It is unclear what happens to colorectal polyp risk after short-term aspirin use. To investigate colorectal polyp risk according to the original trial treatment allocation, up to 6 years after trial participation. All seAFOod trial participants were scheduled for further BCSP surveillance and provided informed consent for the collection of colonoscopy outcomes. We linked BCSP colonoscopy data to trial outcomes data. In total, 507 individuals underwent one or more colonoscopies after trial participation. Individuals grouped by treatment allocation were well matched for clinical characteristics, follow-up duration and number of surveillance colonoscopies. The polyp detection rate (PDR; the number of individuals who had ≥1 colorectal polyp detected) after randomization to placebo aspirin was 71.1%. The PDR was 80.1% for individuals who had received aspirin (odds ratio [OR] 1.13 [95% confidence interval 1.02, 1.24]; p = 0.02). There was no difference in colorectal polyp outcomes between individuals who had been allocated to EPA compared with its placebo (OR for PDR 1.00 [0.91, 1.10]; p = 0.92). Individuals who received aspirin in the seAFOod trial demonstrated increased colorectal polyp risk during post-trial surveillance. Rebound elevated neoplastic risk after short-term aspirin use has important implications for aspirin cessation driven by age-related bleeding risk. ISRCTN05926847.

TransResU-Net: A Transformer based ResU-Net for Real-Time Colon Polyp Segmentation.

Colorectal cancer (CRC) is one of the most common causes of cancer and cancer-related mortality worldwide. Performing colon cancer screening in a timely fashion is the key to early detection. Colonoscopy is the primary modality used to diagnose colon cancer. However, the miss rate of polyps, adenomas and advanced adenomas remains significantly high. Early detection of polyps at the precancerous stage can help reduce the mortality rate and the economic burden associated with colorectal cancer. Deep learning-based computer-aided diagnosis (CADx) system may help gastroenterologists to identify polyps that may otherwise be missed, thereby improving the polyp detection rate. Additionally, CADx system could prove to be a cost-effective system that improves long-term colorectal cancer prevention. In this study, we proposed a deep learning-based architecture for automatic polyp segmentation called Transformer ResU-Net (TransResU-Net). Our proposed architecture is built upon residual blocks with ResNet-50 as the backbone and takes advantage of the transformer self-attention mechanism as well as dilated convolution(s). Our experimental results on two publicly available polyp segmentation benchmark datasets showed that TransResU-Net obtained a highly promising dice score and a real-time speed. With high efficacy in our performance metrics, we concluded that TransResU-Net could be a strong benchmark for building a real-time polyp detection system for the early diagnosis, treatment, and prevention of colorectal cancer. The source code of the proposed TransResU-Net is publicly available at https://github.com/nikhilroxtomar/TransResUNet.

2L polyethylene glycol combined with castor oil versus 4L polyethylene glycol for bowel preparation before colonoscopy among inpatients.

Inpatients are more likely to have inadequate bowel preparation compared to outpatients. Although experts recommend 4L split polyethylene glycol (PEG) preparation, bowel preparation with castor oil (CaO) was recently found to reduce the volume of solution required. The aim of the study was to evaluate the cleansing effect and safety of 2L-PEG with Cao in bowel preparation among inpatients. Our study retrospectively analyzed the medical records and colonoscopy reports of inpatients (n = 1251) who underwent colonoscopy in the Affiliated Changzhou No.2 People Hospital of Nanjing Medical University, and the inpatients were divided into 2L-PEG-CaO and 4L-PEG group according to different bowel preparation protocols. Boston Bowel Preparation Scale (BBPS) is used to assess bowel preparation efficacy before colonoscopy. Furthermore, we also calculated other outcomes, such as polyp or adenoma detection rates and adverse events. A total of 1251 patients undergoing colonoscopy were included in this study, 738 were taken 4L-PEG and 513 2L-PEG-CaO. Both inpatients groups were matched for baseline characteristics. The 2L-PEG-CaO group was significantly higher than the 4L-PEG group on both BBPS (7.26 ± 1.75 vs 7.06 ± 1.58, P = .043) and adequate bowel cleansing rates (83.2% vs 77.4%, P = .011). Regarding adverse events, the 4L-PEG group was significantly higher than the 2L-PEG-CaO group on the incidence of abdominal fullness (6.4% vs 9.6%, P = .045) and adverse events (33.7% vs 28.5%, P = .048). The 2L split PEG with CaO preparation increased quality of bowel cleansing and improved tolerance in inpatients. Bowel preparation with 2L-PEG-CaO is suitable alternative to traditional 4L split PEG bowel preparation for colonoscopy of inpatients.

Higher Serrated Polyp Detection Rates Are Associated With Lower Risk of Postcolonoscopy Colorectal Cancer: Data From the New Hampshire Colonoscopy Registry.

We used New Hampshire Colonoscopy Registry data to examine the association between postcolonoscopy colorectal cancer (PCCRC) and sessile serrated detection rates (SSLDRs). We included patients with either a colonoscopy or a CRC diagnosis in the NH State Cancer Registry. PCCRC was any CRC diagnosed ≥ 6 months after index examination. Of 26,901 patients, 162 were diagnosed with PCCRC. The hazard ratio for PCCRC was lowest for patients whose endoscopists had the highest SSLDR quintile (≥6%) (hazard ratio 0.29; 95% confidence interval 0.16-0.50). Endoscopists with higher SSLDRs had lower risks of PCCRC. These data validate SSLDR as a clinically relevant quality measure.

Real-Time Artificial Intelligence-Assisted Colonoscopy and the Effect of Endoscopist Experience on Polyp Detection Rates at a Tertiary Referral Center

Abstract Background: In recent years, new technology has emerged with the potential to considerably influence the future landscape of gastrointestinal endoscopy. One example of this is real-time artificial intelligence-assisted colonoscopy (AIC). Reported improvements in polyp detection rate (PDR) and adenoma detection rate (ADR) over standard colonoscopy (SC) have led to its rapid adoption in several tertiary endoscopy centers worldwide. However, many clinicians have mixed attitudes concerning the use of AIC. Similar to other skill-based procedures, the quality of endoscopy is directly proportional to the technical expertise and proficiency of the endoscopist. Objective: To evaluate the use of real-time AIC versus SC at a tertiary, high-volume referral center. Design: Retrospective cohort study. Settings: Single tertiary referral center. Patient and Methods: Data was retrospectively analyzed from patients who underwent elective colonoscopy at Singapore General Hospital from August 1, 2022 to October 31, 2022. Main Outcome Measures: The primary study outcome was PDR and ADR. Subgroup analysis assessed the differences in polyp detection according to the experience level of the endoscopist. Sample Size: Eight hundred and fifty-nine patients. Results: Over the 3-month study period, 859 patients underwent complete colonoscopies performed by nine accredited endoscopists; 430 patients underwent SC and 429 underwent AIC. Both groups were statistically similar in age, gender, and indication for colonoscopy. The median ADR was 34.2% (range, 24.6%–57.3%) for the entire cohort. Overall detection rates were higher for AIC than SC for diminutive polyps (≤5 mm) (45.7% vs 38.6%, P = 0.045), sessile polyps (48.5% vs 37.4%, P = 0.009), and polyps with adenomatous (42.4% vs. 36.3%, P = 0.043) or serrated histology (1.2% vs. 0%, P = 0.025). Using SC, PDR among junior versus senior endoscopists was comparable at 47.9% vs 45.6% (P = 0.672) and ADR at 36.1% vs 36.8% (P = 0.912). With real-time AI enhancement, PDR and ADR for junior endoscopists considerably increased over their senior counterparts, with PDR at 69.5% vs 44.9% (P = 0.0001) and ADR at 50.0% vs 37.7% (P = 0.016). Among senior endoscopists, AIC did not result in any statistical improvement of PDR (P = 0.999) and ADR (P = 0.854) compared to SC. Conclusions: AIC significantly increases PDR and ADR compared to SC, particularly for detecting diminutive and sessile polyps. This benefit was only observed among less experienced endoscopists. Limitations: This study is limited by its retrospective nature, short study duration, and availability of the AI system, leading to practical constraints. Conflict of Interest: The authors have no conflict of interest to declare.

Identifying the need for a UK colorectal cancer screening programme for patients with cystic fibrosis (CF): 10-year retrospective review of colonoscopy and colorectal cancer outcomes at a single CF centre

ObjectivePatients with cystic fibrosis (pwCF) have a high incidence of early colorectal cancer (CRC). In the absence of a UK CRC screening programme for pwCF, we evaluated the utility and...

Blue-light imaging or narrow-band imaging for proximal colonic lesions: a prospective randomized tandem colonoscopy study

Blue-light imaging (BLI) is a new image-enhanced endoscopy with a wavelength filter similar to narrow-band imaging (NBI). We compared the 2 with white-light imaging (WLI) on proximal colonic lesion detection and miss rates. In this 3-arm prospective randomized study with tandem examination of the proximal colon, we enrolled patients aged≥40 years. Eligible patients were randomized in 1:1:1 ratio to receive BLI, NBI, or WLI during the first withdrawal from the proximal colon. The second withdrawal was performed using WLI in all patients. Primary outcomes were proximal polyp (pPDRs) and adenoma (pADRs) detection rates. Secondary outcomes were miss rates of proximal lesions found on tandem examination. Of 901 patients included (mean age, 64.7 years; 52.9% men), 48.1% underwent colonoscopy for screening or surveillance. The corresponding pPDRs of the BLI, NBI, and WLI groups were 45.8%, 41.6, and 36.6%, whereas the corresponding pADRs were 36.6%, 33.8%, and 28.3%. There was a significant difference in pPDR and pADR between BLI and WLI groups (difference, 9.2% [95% confidence interval {CI}, 3.3-16.9] and 8.3% [95% CI, 2.7-15.9]) and between NBI and WLI groups (difference, 5.0% [95% CI, 1.4-12.9] and 5.6% [95% CI, 2.1-13.3]). Proximal adenoma miss rates were significantly lower with BLI (19.4%) than with WLI (27.4%; difference, -8.0%; 95% CI, -15.8 to -.1) but not between NBI (27.2%) and WLI. Both BLI and NBI were superior to WLI on detecting proximal colonic lesions, but only BLI had lower proximal adenoma miss rates than WLI. (Clinical trial registration number: NCT03696992.).

Effectiveness of using a patient education mobile application to improve the quality of bowel preparation: a randomised controlled trial

AimsTo determine the effectiveness of a mobile application (app) in improving the quality of bowel preparation for colonoscopy.MethodAn endoscopist-blinded randomised controlled trial enrolled patients who were undergoing a colonoscopy on...

Quality in colonoscopy: time to ensure national standards are implemented?

BackgroundHigh-quality colonoscopy is crucial to ensure complete mucosal visualisation and to maximise detection of pathology. Previous audits showing variable quality have prompted national and international colonoscopy improvement programmes, including the...

The Efficacy of AI-Assisted CADe Systems in Colorectal Polyps and Adenomas during Colonoscopies: A Systematic Review

Colorectal polyps and adenomas are a significant health concern that can lead to colorectal cancer. Detecting polyps and adenomas early is important to remove them in a timely manner, reducing the risk of cancer. Artificial intelligence (AI) could assist in identifying polyps and adenomas more efficiently. This study will investigate the potential benefits of AI technology in detecting colorectal adenomas, using AI-assisted colonoscopy diagnostic systems. The goal is to determine if there are differences in detection rates using AI compared to standard colonoscopy methods. PRISMA Statement 2020 guidelines were adhered to in this systematic review. Three databases were searched including PubMed/MEDLINE, Embase and Web of Science through February 23, 2023. A combination of the following keywords was used: AI, Artificial, Intelligence, Colorectal, Polyp, Adenoma. The adenoma detection rate (ADR) and polyp detection rate (PDR) were additionally meta-analyzed for proportions, and reported as odds ratio (OR), applying 95% confidence intervals (CI). A total of 9 randomized clinical trials were included in this review, pooling in 6981 participants. The findings were presented systematically, based on the design, technology used, effects on ADR and PDR, and key conclusions. The meta-analytical findings were reported as follows. On applying a random-effects model, the odds ratio (OR) for ADR was 1.532 (95% CI=1.125-2.087), with significant detection favoring CADe systems (P=0.0068). Similarly, when assessing the chance of diagnosing colorectal polyps with CADe systems as an add-on compared to standard colonoscopy alone, the odds ratio (OR) was 1.893 (95% CI=1.687-2.125, P&lt;0.0001). This systematic review found that real-time computer-aided detection during colonoscopy improved the detection of adenomas and polyps. The use of the system is feasible and safe, and future studies should focus on improving colonoscopy quality indicators including the most widely used– ADR. Larger randomized controlled studies are needed to evaluate the impact of this system on adenoma and serrated polyp detection and its effect on endoscopists with lower detection rates.