AI-assisted colonoscopy boosts polyp and adenoma detection

MedTech & Diagnostics News: In a standard colonoscopy, as many as one-third of colorectal polyps and adenomas can go by undetected. A systematic review of randomised clinical trials (RCTs) comparing computer-aided detection (CADe) system-enhanced colonoscopy and conventional colonoscopy found that CADe (artificial Intelligence- or AI-assisted) colonoscopies increase overall detection of colonic polyps and adenomas, or precancerous growths, with a small increase in procedure time.

Medtronic’s GI Genius processes colonoscopy imaging data in real time uses its AI to automatically spot colorectal polyps of all shapes and sizes. In a study, just about 15% of polyps were missed when the AI system was used during the exam, compared to a miss rate of more than 32% in colonoscopies without AI assistance.

Last month, Olympus announced the FDA approval of its Odin Medical which could potentially go up against the GI Genius platform. Prior to this, Olympus introduced its ENDO-AID AI-powered endoscopy platform in Australia.

According to Bowel Cancer Australia, almost 99% of bowel cancer rates can be treated successfully when detected early – this is the primary benefit of this kind of technology.

In the systemic review, equivocal results were found regarding detection of advanced colonic neoplasia (ACN), with a small increase in ACN detection rate but no difference in ACN detected per colonoscopy.

The authors compared average adenoma per colonoscopy (APC) and ACN per colonoscopy for both screening methods. Secondarily, they compared adenoma detection rate (ADR), adenoma miss rate (AMR), and ACN detection rate between the two colonoscopy types.

They found that AI-assisted colonoscopy found more polyps and precancerous growths in the colon than conventional colonoscopy. However, AI-assisted colonoscopy detected marginally more serious growths (ACNs) than conventional colonoscopy but was no better than the conventional method at finding ACNs per colonoscopy.

The researchers note that there are no clear differences in benefit for detecting adenomas across different AI systems for CADe, and that there was an increase in benefit for providers with lower adenoma detection rate or those without a prior faecal immunochemical test (FIT) result.

The systemic review authors suggest that future studies focus on interval post colonoscopy colorectal cancer and may consider a study design that randomises colonoscopists rather than patients.

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