Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias : A Randomized Trial.
Journal
Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
medline:
20
9
2023
pubmed:
28
8
2023
entrez:
28
8
2023
Statut:
ppublish
Résumé
The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown. To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions. Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136). Spanish colorectal cancer screening program. 3213 persons with a positive fecal immunochemical test. Enrollees were randomly assigned to colonoscopy with or without computer-aided detection. Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp. The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy. The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates. Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias. Medtronic.
Sections du résumé
BACKGROUND
The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown.
OBJECTIVE
To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions.
DESIGN
Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136).
SETTING
Spanish colorectal cancer screening program.
PARTICIPANTS
3213 persons with a positive fecal immunochemical test.
INTERVENTION
Enrollees were randomly assigned to colonoscopy with or without computer-aided detection.
MEASUREMENTS
Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp.
RESULTS
The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy.
LIMITATIONS
The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates.
CONCLUSION
Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias.
PRIMARY FUNDING SOURCE
Medtronic.
Substances chimiques
Radiopharmaceuticals
0
Banques de données
ClinicalTrials.gov
['NCT04673136']
Types de publication
Randomized Controlled Trial
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1145-1152Investigateurs
Carolina Mangas-Sanjuan
(C)
Noelia Sala-Miquel
(N)
Juan Martínez-Sempere
(J)
José R Aparicio
(JR)
Francisco A Ruíz
(FA)
Luis Compañy
(L)
Belén Martínez-Moreno
(B)
Blanca Martínez-Andrés
(B)
Lucía Medina-Prado
(L)
Eva Soriano
(E)
Enrique Santana
(E)
Pedro Zapater
(P)
Rodrigo Jover
(R)
María Pellisé
(M)
Oswaldo Ortiz
(O)
Anna Serradesanferm
(A)
Àngels Pozo
(À)
Anna Porta
(A)
Rebeca Moreira
(R)
María Daca-Álvarez
(M)
Jaume Grau
(J)
Isabel Torà
(I)
Karmele Sáez-de-Gordoa
(K)
Francesc Balaguer
(F)
Eva Vaquero
(E)
Sabela Carballal
(S)
Ingrid Ordás
(I)
Leticia Moreira
(L)
Liseth Rivero
(L)
Joaquín Cubiella-Fernández
(J)
Astrid Díez
(A)
Laura Codesido
(L)
David R Remedios-Espino
(DR)
Sara Zarraquiños
(S)
Jesús M Herrero-Rivas
(JM)
Laura Rivas-Moral
(L)
Manuel Puga
(M)
María J Iglesias-Varela
(MJ)
Noel Pin-Vieito
(N)
Pablo Vega-Villaamil
(P)
Santiago Soto-Iglesias
(S)
Ramiro Macenlle
(R)
Adolfo Suárez
(A)
Eva Barreiro-Alonso
(E)
Lorena Blanco-García
(L)
Miguel Fraile-López
(M)
Olegario Castaño-Fernández
(O)
Óscar L González-Bernardo
(ÓL)
Verónica Álvarez-García
(V)
Víctor Jiménez-Beltrán
(V)
Pilar Díez-Redondo
(P)
Henar Núñez-Rodríguez
(H)
Fátima Sánchez-Martín
(F)
Luisa de-Castro
(L)
Nereida Fernández
(N)
Arantza Germade
(A)
Lucía Cid
(L)
Sara Alonso
(S)
Alfonso Martínez-Turnes
(A)
Beatriz Romero-Mosquera
(B)
Antonio Rodríguez de-Jesús
(A)
Natalia García-Morales
(N)
Romina Fernández-Poceiro
(R)