569: Comparison of Artificial Intelligence With Other Interventions to Improve Adenoma Detection Rate for Colonoscopy: A Network Meta-Analysis of Randomized Controlled Trials

Aziz, Muhammad; Haghbin, Hossein; Sayeh, Wasef; Alfatlawi, Halah; Sharma, Sachit; Weissman, Simcha; Kamal, Faisal; Lee‐Smith, Wade; Nawras, Ali; Sharma, Prateek; Shaukat, Aasma

doi:10.1016/s0016-5085(22)60336-6

Cited by 3 publications

(5 citation statements)

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“…Arguably, combining these three different and complementary device families would have a synergistic effect on lesion detection. Some studies have attempted to pit them against each other to compare their impact on ADR [18], but such competition is arguably neither useful nor reflective of the reality of an endoscopy unit, which can use the devices in combination. Only a few studies to date have evaluated device combinations, with some examining the CADe-contrast-enhaced system pair [19] and others the "CADe-ECV" pair [20,21,22], with the latter pair demonstrating not only a significant increase in ADR but even a notable significant increase in advanced ADR when compared to HD-WLI alone [20].…”

Section: Combining the Optimization Devicesmentioning

confidence: 99%

Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy

Karsenti

2024

Endosc Int Open

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Optimizing the adenoma detection rate (ADR) is a major goal in colorectal cancer (CCR) screening, as it has long been established that ADR is inversely proportional to the risk of post-colonoscopy CRC occurrence. To achieve this goal, many optimization devices have been developed, and numerous randomized controlled trials have been conducted to evaluate the benefits of these devices compared with a "standard arm," which corresponds to date to high-definition white light (HD-WLI) colonoscopy. Numerous studies have confirmed the positive impact of various optimization devices, such as caps, computer-aided detection, and contrast-enhanced technologies. Moreover, the different ways in which the devices can impact ADR make them complementary. However, despite substantial and consistent data, practices remain unchanged, and HD-WLI colonoscopy, considered the "standard," is still routinely performed without any optimization devices. The objective of this viewpoint is to understand the barriers to change and to show why standard screening colonoscopy without the use of any optimization devices should no longer be considered relevant in 2024.

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Section: Combining the Optimization Devicesmentioning

confidence: 99%

Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy

Karsenti

2024

Endosc Int Open

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“…[70][71][72] Additionally, advanced technology aimed at improving ADR can be divided into: (i) mucosal exposure devices such as the Endorings, Endocap, Endocuff, and G-EYE systems; [73][74][75][76] (ii) image enhancement techniques such as dye chromoendoscopy and virtual chromoendoscopy; [77][78][79][80][81] and (iii) computer-aided polyp detection system (CADe), which is the most promising tool. [82][83][84] By a recent meta-analysis, CADe had the most significant improvement in ADR of ~10% in both low and high ADR detectors and 50% reductions in the missing rate in tandem studies compared to mucosal exposure devices and image enhancement techniques. [82][83][84] However, existing studies are limited by unblinded endoscopists and their generalizability.…”

Section: Quality Improvementmentioning

confidence: 99%

“…water‐assisted colonoscopy, right‐sided retroflection, double right‐side examination, and patient position change during scope withdrawal) have improved ADR 70–72 . Additionally, advanced technology aimed at improving ADR can be divided into: (i) mucosal exposure devices such as the Endorings, Endocap, Endocuff, and G‐EYE systems; 73–76 (ii) image enhancement techniques such as dye chromoendoscopy and virtual chromoendoscopy; 77–81 and (iii) computer‐aided polyp detection system (CADe), which is the most promising tool 82–84 . By a recent meta‐analysis, CADe had the most significant improvement in ADR of ~10% in both low and high ADR detectors and 50% reductions in the missing rate in tandem studies compared to mucosal exposure devices and image enhancement techniques 82–84 .…”

Section: Quality Improvementmentioning

confidence: 99%

“…[82][83][84] By a recent meta-analysis, CADe had the most significant improvement in ADR of ~10% in both low and high ADR detectors and 50% reductions in the missing rate in tandem studies compared to mucosal exposure devices and image enhancement techniques. [82][83][84] However, existing studies are limited by unblinded endoscopists and their generalizability. Hence, Digestive Endoscopy 2024; 36: 30-39…”

Section: Quality Improvementmentioning

confidence: 99%

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What are the priority quality indicators for colonoscopy in real‐world clinical practice?

Tiankanon

Aniwan

2023

Digestive Endoscopy

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Colonoscopy is widely used as a colorectal cancer (CRC) screening tool. The effectiveness of a screening colonoscopy is associated with a decreased risk of CRC. However, colonoscopy is an operator‐dependent procedure, and endoscopists' quality performance varies widely. This article reviewed the priority metrics and practices that contribute to high‐quality screening colonoscopy in real‐world clinical practice. With growing evidence, quality indicators have been subject to intense research and associated with reducing postcolonoscopy CRC incidence and mortality. Some quality metrics can reflect an endoscopy unit‐based practice (i.e. quality of bowel preparation and withdrawal time). Other quality indicators primarily reflect individuals' skill and knowledge (i.e. cecal intubation rate, adenoma detection rate, and appropriately assigned follow‐up colonoscopy interval). Measurement and improvement of priority quality indicators for colonoscopy should be made at both the endoscopist and unit levels. Substantial evidence supports the impact of high‐quality colonoscopy in reducing the incidence of postcolonoscopy CRC.

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“…Artificial intelligence has been used as an additional tool for diagnosis and for characterization of colonic lesions. It has been demonstrated that AI increases the adenoma detection rate [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

A Sessile Serrated Lesion Overlying a Submucosal Colonic Lipoma: An Endoscopic Rarity Identified Using Artificial Intelligence

Facanali

Sobrado

et al. 2023

Am J Case Rep

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Patient: Female, 60-year-old Final Diagnosis: Sessile serrated lesion overlying submucosal colonic lipoma Symptoms: She was completely asymptomatic Clinical Procedure: Fecal immunochemical test (FIT) • colonoscopy Specialty: Gastroenterology and Hepatology Objective: Rare coexistence of disease or pathology Background: Lipomas are benign, slow-growing mesenchymal neoplasms, more prevalent in females, with a peak incidence in the fifth to sixth decades of life. Generally, due to their low clinical relevance, they receive little attention in the literature. Uncommon in the colon, lipomas are most often identified as an incidentaloma in asymptomatic patients during colonoscopy, and overlapping with epithelial lesions is a rare finding. Serrated polyps used to be considered as hyperplastic polyps without any malignant potential; however, currently, the serrated pathway accounts for one-third of all colorectal cancers. Here, we describe a rare case of a sessile serrated lesion on a submucosal lipoma identified with the aid of artificial intelligence. Case Report: A 60-year-old woman underwent screening colonoscopy for colorectal cancer after a positive fecal immunochemical test. A high-definition colonoscopy with the aid of artificial intelligence (Fujifilm CAD EYE) was performed. A flat lesion at the right colon was diagnosed with white-light endoscopy simultaneously identified by artificial intelligence, which classified the lesion as hyperplastic. Resection was performed through mucosectomy, and a sign of naked fat was observed at the base of the resected lesion. Histopathology of the specimen characterized a submucosal lipoma associated with a sessile serrated lesion. Conclusions: We describe a rare case of sessile serrated lesion on a colon lipoma, identified with the aid of artificial intelligence. We carried out a brief literature review and discussed the main findings and aspects related to the literature.

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569: Comparison of Artificial Intelligence With Other Interventions to Improve Adenoma Detection Rate for Colonoscopy: A Network Meta-Analysis of Randomized Controlled Trials

Cited by 3 publications

References 0 publications

Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy

Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy

What are the priority quality indicators for colonoscopy in real‐world clinical practice?

A Sessile Serrated Lesion Overlying a Submucosal Colonic Lipoma: An Endoscopic Rarity Identified Using Artificial Intelligence

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