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In Gastrointestinal endoscopy ; h5-index 72.0

BACKGROUND AND STUDY AIMS : Artificial intelligence-based computer-aid detection (CADe) devices have been recently tested in colonoscopies, increasing the adenoma detection rate (ADR), mainly in Asian populations. However, there is still low evidence for the benefit of these devices in the occidental population. We tested a new CADe device, namely, ENDO-AID (OIP-1) (Olympus, Japan), in clinical practice.

PATIENTS AND METHODS : This randomized controlled trial included 370 consecutive patients who were randomized 1:1 to CADe (n=185) versus standard exploration (n=185) from November 2021 to January 2022. The primary endpoint was the ADR. Advanced adenoma was defined as ≥ 10mm, harboring high grade dysplasia or with villous pattern. Otherwise, the adenoma was nonadvanced. ADR was assessed in both groups stratified by endoscopist ADR and colon cleansing.

RESULTS : In the intention-to-treat analysis the ADR was 55.1% (n=102/185) in the CADe group and 43.8% (n=81/185) in the control group (P=0.029). Nonadvanced ADRs (54.8% vs. 40.8%, P=0.01) and flat ADRs (39.4 vs. 24.8, P=0.006), polyp detection rate (67.1% vs. 51%; P=0.004) and number of adenomas per colonoscopy were significantly higher in the CADe group than in the control group (median [Percentile 25th-75th]: 1 [0-2] vs. 0 [0-1.5], respectively; p= 0.014). No significant differences were found in serrated adenoma detection rate. After stratification by endoscopist and bowel cleansing, no statistically significant differences in ADR were found.

CONCLUSION : Colonoscopy assisted by ENDO-AID (OIP-1) increases ADR and APC, suggesting that it may prevent the overlooking of colorectal neoplastic lesions, especially because of its detection of diminutive and flat adenomas.

Gimeno-García Antonio Z, Negrin Domingo Hernández, Hernández Anjara, Nicolás-Pérez David, Rodríguez Eduardo, Montesdeoca Carlota, Alarcon Onofre, Romero Rafael, Baute Dorta José Luis, Cedrés Yaiza, Castillo Rocío Del, Jiménez Alejandro, Felipe Vanessa, Morales Dalia, Ortega Juan, Reygosa Cristina, Quintero Enrique, Hernández-Guerra Manuel


ADR, CADe, Computer-assisted lesion detection devices, adenoma detection rate, colonoscopy