Background and Aims
Computer-aided detection (CADe) and a mucosal exposure device can improve adenoma
detection rate (ADR). Potential benefits of combining the 2 modalities have never
been studied. This study aimed to compare ADR differences among CADe alone, endocuff-assisted
colonoscopy (EAC) alone, and the combination of CADe and EAC (CADe+EAC) with standard
colonoscopy.
Methods
This prospective randomized controlled study included 1245 participants who underwent
screening colonoscopy. Participants were randomized to CADe, EAC, CADe+EAC, and standard
colonoscopy as a control. The primary outcome was ADR. Secondary outcomes were proximal
ADR (pADR), advanced ADR (AADR), and the number of adenomas per colonoscopy (APCs).
Results
ADRs from the control, CADe, EAC, and CADe+EAC groups were 41.9%, 52.2%, 54.0%, and
58.8%, respectively; pADRs were 25.2%, 33.3%, 34.9%, and 37.0%, respectively; AADRs
were 7.7%, 8.3%, 8.3%, and 13.6%, respectively; and APCs were .76, 1.11, 1.18, and
1.31, respectively. Significant increases in ADR and pADR were observed between the
intervention and control groups (P < .05 in all comparisons). The AADR was significantly higher only in the CADe+EAC
group than in the control group (P = .02). The adjusted incidence rate ratios of APCs were significantly higher in the
intervention groups versus the control group (P < .01 in all comparisons).
Conclusions
CADe+EAC significantly improve ADR and AADR over standard colonoscopy. However, although
CADe or EAC alone can substantially increase the detection of adenomas, they do not
lead to increased detection of advanced adenomas unless used in combination. (Clinical
trial registration number: TCTR20200929003.)
Abbreviations:
AADR (advanced adenoma detection rate), ADR (adenoma detection rate), APC (adenoma per colonoscopy), CADe (computer-aided detection), CI (confidence interval), CRC (colorectal cancer), EAC (endocuff-assisted colonoscopy), IRR (incidence rate ratio), pADR (proximal adenoma detection rate), pAPC (proximal adenomas per colonoscopy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 08, 2022
Accepted:
September 23,
2022
Received:
June 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
DISCLOSURE: All authors disclosed no financial relationships. Research support for this study was provided to Dr. Rungsun Rerknimitr by the National Research Council of Thailand (N42A640330); to Dr. Satimai Aniwan by the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University (RA65_CRC_003); and Fujifilm (provided CAD EYE).
DIVERSITY, EQUITY, AND INCLUSION: We worked to ensure gender balance in the recruitment of human subjects. We worked to ensure ethnic or other types of diversity in the recruitment of human subjects. The author list of this paper includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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© 2022 by the American Society for Gastrointestinal Endoscopy
