Automated polyp detection in the colorectum: a prospective study (with videos).


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
03 2019
Historique:
received: 25 05 2018
accepted: 30 09 2018
pubmed: 21 10 2018
medline: 14 6 2019
entrez: 21 10 2018
Statut: ppublish

Résumé

Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions. This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard. The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS. Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).

Sections du résumé

BACKGROUND AND AIMS
Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions.
METHODS
This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard.
RESULTS
The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS.
CONCLUSION
Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).

Identifiants

pubmed: 30342029
pii: S0016-5107(18)33175-4
doi: 10.1016/j.gie.2018.09.042
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02838888']

Types de publication

Journal Article Observational Study Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

576-582.e1

Informations de copyright

Copyright © 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Peter Klare (P)

Klinik für Innere Medizin II, Munich, Germany.

Christoph Sander (C)

Klinik für Innere Medizin II, Munich, Germany.

Martin Prinzen (M)

Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Germany.

Bernhard Haller (B)

Institut für Medizinische Informatik, Statistik und Epidemiologie, Munich, Germany.

Sebastian Nowack (S)

Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Germany.

Mohamed Abdelhafez (M)

Klinik für Innere Medizin II, Munich, Germany.

Alexander Poszler (A)

Klinik für Innere Medizin II, Munich, Germany.

Hayley Brown (H)

Klinik für Innere Medizin II, Munich, Germany.

Dirk Wilhelm (D)

MITI Forschungsgruppe am Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.

Roland M Schmid (RM)

Klinik für Innere Medizin II, Munich, Germany.

Stefan von Delius (S)

Medizinische Klinik II, RoMed Klinikum Rosenheim, Rosenheim, Germany.

Thomas Wittenberg (T)

Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Germany.

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Classifications MeSH