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Gastrointest Endosc. 2019 Mar;89(3):576-582.e1. doi: 10.1016/j.gie.2018.09.042. Epub 2018 Oct 17.

Automated polyp detection in the colorectum: a prospective study (with videos).

Author information

1
Klinik für Innere Medizin II, Munich, Germany.
2
Fraunhofer-Institut für Integrierte Schaltungen IIS, Erlangen, Germany.
3
Institut für Medizinische Informatik, Statistik und Epidemiologie, Munich, Germany.
4
MITI Forschungsgruppe am Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
5
Medizinische Klinik II, RoMed Klinikum Rosenheim, Rosenheim, Germany.

Abstract

BACKGROUND AND AIMS:

Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions.

METHODS:

This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard.

RESULTS:

The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS.

CONCLUSION:

Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps. (Clinical trial registration number: NCT02838888.).

PMID:
30342029
DOI:
10.1016/j.gie.2018.09.042
[Indexed for MEDLINE]

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