Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis
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Background/Aims: Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection ofadenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopyare currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods: A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized bymorphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportionsand their differences were calculated using DerSimonian and Laird random-effects modeling. Results: Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assistedcolonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared withconventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09−0.18); it also demonstrated a 91.7% increasein the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02−0.07). Conclusions: CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although thismethod is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.
Abstract
Background/Aims: Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection ofadenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopyare currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods: A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized bymorphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportionsand their differences were calculated using DerSimonian and Laird random-effects modeling. Results: Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assistedcolonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared withconventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09−0.18); it also demonstrated a 91.7% increasein the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02−0.07). Conclusions: CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although thismethod is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.
참고문헌 (30)
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