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Endoscopy. 2016 Dec;48(12):1110-1118. Epub 2016 Aug 5.

Impact of an automated system for endocytoscopic diagnosis of small colorectal lesions: an international web-based study.

Author information

1
Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
2
Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
3
Endoscopy Unit, Lyell McEwin Hospital and University of Adelaide, Adelaide, Australia.
4
Digestive Disease Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan.
5
Locus Logic, Inc., Nagoya, Japan.
6
Graduate School of Information Science, Nagoya University, Nagoya, Japan.
7
Information and Communications, Nagoya University, Nagoya, Japan.

Abstract

Background and study aims: Optical diagnosis of colorectal polyps is expected to improve the cost-effectiveness of colonoscopy, but achieving a high accuracy is difficult for trainees. Computer-aided diagnosis (CAD) is therefore receiving attention as an attractive tool. This study aimed to validate the efficacy of the latest CAD model for endocytoscopy (380-fold ultra-magnifying endoscopy). Patients and methods: This international web-based trial was conducted between August and November 2015. A web-based test comprising one white-light and one endocytoscopic image of 205 small colorectal polyps (≤ 10 mm) from 123 patients was undertaken by both CAD and by endoscopists (three experts and ten non-experts from three countries). Outcome measures were accuracy in identifying neoplastic change in diminutive (≤ 5 mm) and small (≤ 10 mm) polyps, and accuracy in predicting post-polypectomy surveillance intervals according to current guidelines for high confidence optical diagnoses of diminutive polyps. Results: Of the 205 small polyps (147 neoplastic and 58 non-neoplastic), 139 were diminutive. CAD was accurate for 89 % (95 % confidence interval [CI] 83 % - 94 %) of diminutive polyps and 89 % (84 % - 93 %) of small polyps, which was significantly greater than results for the non-experts (73 % [71 % - 76 %], P < 0.001; and 76 % [74 % - 78 %], P < 0.001, respectively) and comparable with the experts' results (90 % [87 % - 93 %], P = 0.703; and 91 % [89 % - 93 %], P = 0.106, respectively). The surveillance interval predicted by CAD provided 98 % (93 % - 100 %) and 96 % (91 % - 99 %) agreement with pathology-directed intervals of the European and American guidelines, respectively. Conclusions: The use of CAD in endocytoscopy can be effective in the management of diminutive/small colorectal polyps.UMIN Clinical Trial Registry: UMIN000018185.

PMID:
27494455
DOI:
10.1055/s-0042-113609
[Indexed for MEDLINE]

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