دورية أكاديمية

Endocuff With or Without Artificial Intelligence-Assisted Colonoscopy in Detection of Colorectal Adenoma: A Randomized Colonoscopy Trial.

التفاصيل البيبلوغرافية
العنوان: Endocuff With or Without Artificial Intelligence-Assisted Colonoscopy in Detection of Colorectal Adenoma: A Randomized Colonoscopy Trial.
المؤلفون: Lui TK; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Lam CP; Department of Medicine, Queen Mary Hospital, Hong Kong, China., To EW; Department of Medicine, Queen Mary Hospital, Hong Kong, China.; Department of Medicine, Tung Wah Hospital, Hong Kong, China., Ko MK; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Tsui VWM; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Liu KS; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Hui CK; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Cheung MK; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Mak LL; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Hui RW; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Wong SY; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Seto WK; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.; Department of Medicine, Queen Mary Hospital, Hong Kong, China., Leung WK; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.; Department of Medicine, Queen Mary Hospital, Hong Kong, China.
المصدر: The American journal of gastroenterology [Am J Gastroenterol] 2024 Jul 01; Vol. 119 (7), pp. 1318-1325. Date of Electronic Publication: 2024 Feb 02.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 0421030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-0241 (Electronic) Linking ISSN: 00029270 NLM ISO Abbreviation: Am J Gastroenterol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2019-> : [Philadelphia, PA] : Wolters Kluwer Health
Original Publication: New York, Elsevier Science, -2003.
مواضيع طبية MeSH: Colonoscopy*/methods , Adenoma*/diagnosis , Adenoma*/diagnostic imaging , Colorectal Neoplasms*/diagnosis , Colorectal Neoplasms*/diagnostic imaging , Artificial Intelligence*, Humans ; Male ; Female ; Aged ; Middle Aged ; Prospective Studies ; Colonic Polyps/diagnosis ; Colonic Polyps/diagnostic imaging ; Adult
مستخلص: Introduction: Both artificial intelligence (AI) and distal attachment devices have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. We studied the combined effect of Endocuff and AI on enhancing detection rates of various colonic lesions.
Methods: This was a 3-arm prospective randomized colonoscopy study involving patients aged 40 years or older. Participants were randomly assigned in a 1:1:1 ratio to undergo Endocuff with AI, AI alone, or standard high-definition (HD) colonoscopy. The primary outcome was adenoma detection rate (ADR) between the Endocuff-AI and AI groups while secondary outcomes included detection rates of polyp (PDR), sessile serrated lesion (sessile detection rate [SDR]), and advanced adenoma (advanced adenoma detection rate) between the 2 groups.
Results: A total of 682 patients were included (mean age 65.4 years, 52.3% male), with 53.7% undergoing diagnostic colonoscopy. The ADR for the Endocuff-AI, AI, and HD groups was 58.7%, 53.8%, and 46.3%, respectively, while the corresponding PDR was 77.0%, 74.0%, and 61.2%. A significant increase in ADR, PDR, and SDR was observed between the Endocuff-AI and AI groups (ADR difference: 4.9%, 95% CI: 1.4%-8.2%, P = 0.03; PDR difference: 3.0%, 95% CI: 0.4%-5.8%, P = 0.04; SDR difference: 6.4%, 95% CI: 3.4%-9.7%, P < 0.01). Both Endocuff-AI and AI groups had a higher ADR, PDR, SDR, and advanced adenoma detection rate than the HD group (all P < 0.01).
Discussion: Endocuff in combination with AI further improves various colonic lesion detection rates when compared with AI alone.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
References: Globocan2020. Colorectal cancer. International Agency for Research of Cancer: Lyon, France ( https://gco.iarc.fr/today/data/factsheets/cancers/10&#95;8&#95;9-Colorectum-fact-sheet.pdf ) (Accessed March 10, 2023).
Yiu HHY. Overview of Hong Kong Cancer Statistics of 2020. Hong Kong Cancer Registry Hospital Authority: Hong Kong, 2020.
Zauber AG, Winawer SJ, O'Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012;366(8):687–96.
Cheung KS, Chen L, Seto WK, et al. Epidemiology, characteristics, and survival of post-colonoscopy colorectal cancer in Asia: A population-based study. J Gastroenterol Hepatol 2019;34(9):1545–53.
Wang P, Berzin TM, Glissen Brown JR, et al. Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: A prospective randomised controlled study. Gut 2019;68(10):1813–9.
Wang P, Liu XG, Berzin TM, et al. Effect of a deep-learning computer-aided detection system on adenoma detection during colonoscopy (CADe-DB trial): A double-blind randomised study. Lancet Gastroenterol Hepatol 2020;5(4):343–51.
Repici A, Badalamenti M, Maselli R, et al. Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Gastroenterology 2020;159(2):512–20.e7.
Gong D, Wu L, Zhang J. Detection of colorectal adenomas with a real-time computer-aided system (ENDOANGEL): A randomised controlled study. Lancet Gastroenterol Hepatol 2020;5:352–61.
Su JR, Li Z, Shao XJ, et al. Impact of a real-time automatic quality control system on colorectal polyp and adenoma detection: A prospective randomized controlled study (with videos). Gastrointest Endosc 2020;91(2):415–24.e4.
Wang P, Liu P, Glissen Brown JR, et al. Lower adenoma miss rate of computer-aided detection-assisted colonoscopy vs routine white-light colonoscopy in a prospective tandem study. Gastroenterology 2020;159(4):1252–61.e5.
Lui TK, Hui CK, Tsui VW, et al. New insights on missed colonic lesions during colonoscopy through artificial intelligence-assisted real-time detection (with video). Gastrointest Endosc 2021;93(1):193–200.e1.
Rex DK, Sagi SV, Kessler WR, et al. A comparison of 2 distal attachment mucosal exposure devices: A noninferiority randomized controlled trial. Gastrointest Endosc 2019;90(5):835–40.e1.
Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: A systematic review and meta-analysis. Gastroenterology 2019;156(6):1661–74.e11.
Rameshshanker R, Tsiamoulos Z, Wilson A, et al. Endoscopic cuff-assisted colonoscopy versus cap-assisted colonoscopy in adenoma detection: Randomized tandem study-DEtection in tandem endocuff cap trial (DETECT). Gastrointest Endosc 2020;91(4):894–904.e1.
Triantafyllou K, Polymeros D, Apostolopoulos P, et al. Endocuff-assisted colonoscopy is associated with a lower adenoma miss rate: A multicenter randomized tandem study. Endoscopy 2017;49(11):1051–60.
Leung WK, Lo OS, Liu KS, et al. Detection of colorectal adenoma by narrow band imaging (HQ190) vs. high-definition white light colonoscopy: A randomized controlled trial. Am J Gastroenterol 2014;109(6):855–63.
Ngu WS, Bevan R, Tsiamoulos ZP, et al. Improved adenoma detection with endocuff vision: The ADENOMA randomised controlled trial. Gut 2019;68(2):280–8.
Triantafyllou K, Gkolfakis P, Tziatzios G, et al. Effect of endocuff use on colonoscopy outcomes: A systematic review and meta-analysis. World J Gastroenterol 2019;25(9):1158–70.
Hassan C, Spadaccini M, Mori Y, et al. Real-time computer-aided detection of colorectal neoplasia during colonoscopy: A systematic review and meta-analysis. Ann Intern Med 2023;176(9):1209–20.
Kieser M, Friede T. Planning and analysis of three-arm non-inferiority trials with binary endpoints. Stat Med 2007;26(2):253–73.
Stucke K, Kieser M. A general approach for sample size calculation for the three-arm “gold standard” non-inferiority design. Stat Med 2012;31(28):3579–96.
Bretz F, Hothorn T, Westfall P. Multiple Comparisons Using R. CRC Press LLC: London, United Kingdom, 2010.
Aniwan S, Mekritthikrai K, Kerr SJ, et al. Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: A randomized controlled trial. Gastrointest Endosc 2023;97(3):507–16.
Spadaccini M, Hassan C, Rondonotti E, et al. Combination of mucosa-exposure device and computer-aided detection for adenoma detection during colonoscopy: A randomized trial. Gastroenterology 2023;165(1):244–51.e3.
Rex DK, Slaven JE, Garcia J, et al. Endocuff vision reduces inspection time without decreasing lesion detection: A clinical randomized trial. Clin Gastroenterol Hepatol 2020;18(1):158–62.e1.
سلسلة جزيئية: ClinicalTrials.gov NCT05133544
تواريخ الأحداث: Date Created: 20240202 Date Completed: 20240703 Latest Revision: 20240725
رمز التحديث: 20240726
مُعرف محوري في PubMed: PMC11208055
DOI: 10.14309/ajg.0000000000002684
PMID: 38305278
قاعدة البيانات: MEDLINE