Background: Independent use of artificial intelligence with computer-aided detection (CADe) and Endocuff Vision (ECV) has demonstrated enhanced adenoma detection rates (ADRs).
Objective: Our pilot study aimed to define the necessary participant number for future randomized controlled trials (RCTs) by comparing the ADR of combined CADe + ECV against CADe alone and standard colonoscopy.
Design: This single-center pilot study retrospectively analyzed a prospectively maintained database, where patients underwent screening colonoscopies sequentially by standard method, CADe alone, and then CADe + ECV.
Method: The allocation of the technique depended on the study period. Patients were randomly selected from the cohort to form three groups of 30 patients, with stratification based on factors influencing the ADR. The primary endpoint was the ADR.
Results: From April to June 2021, 244 patients underwent screening colonoscopy. 198 were eligible, and after randomization, 90 patients were included across three groups (colonoscopy n = 30, CADe n = 30, CADe + ECV = 30). The ADR was higher in the CADe + ECV group compared to the CADe and colonoscopy groups: 60% versus 40%, and 30%, respectively (p = 0.03). The number of polyps ⩽3 mm detected was greater in the CADe + ECV group (n = 23) versus CADe (n = 7) and colonoscopy (n = 12) groups, respectively (p = 0.03). CADe + ECV identified more polyps in the cecum/right colon (n = 26) compared to CADe (n = 18) and colonoscopy (n = 12) groups (p = 0.04), and in the left colon/sigmoid (n = 14) compared to CADe (n = 5) and colonoscopy (n = 2) (p = 0.02).
Conclusion: These findings underscore the synergic potential of combining CADe with ECV to enhance ADR and enable us to perform sample size calculations for future RCTs.
Registration: Clinical Trials number: NCT05080088. Registration 06/06/2021.
Keywords: adenoma detection rate; artificial intelligence; colonoscopy; colorectal cancer screening; innovation.
Improving polyp detection during colonoscopy: comparing three techniques Colorectal cancer is a leading cause of cancer-related deaths, and early detection of adenomas (precancerous polyps) during colonoscopy is crucial in preventing this disease. Our study aimed to evaluate the effectiveness of three different colonoscopy techniques in detecting adenomas: standard colonoscopy, colonoscopy with computer-aided detection (CADe), and colonoscopy combining CADe with Endocuff Vision (ECV). We conducted a pilot study with 90 patients, divided into three groups of 30 each. One group underwent standard colonoscopy, another had colonoscopy with CADe, and the third group experienced colonoscopy with both CADe and ECV. Our results showed that the combined CADe + ECV technique detected the highest number of adenomas, significantly outperforming both standard colonoscopy and CADe alone. Specifically, 60% of patients in the CADe + ECV group had adenomas detected, compared to 40% in the CADe group and 30% in the standard colonoscopy group. This study highlights the potential benefits of using advanced technologies like CADe and ECV together to improve adenoma detection rates during colonoscopy, ultimately aiding in better prevention of colorectal cancer. Future larger-scale studies are needed to confirm these findings and refine the use of these technologies in clinical practice.
© The Author(s), 2024.