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Automated polyp detection in the colorectum: a prospective study (with videos)
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2018-10-17 , DOI: 10.1016/j.gie.2018.09.042
Peter Klare , Christoph Sander , Martin Prinzen , Bernhard Haller , Sebastian Nowack , Mohamed Abdelhafez , Alexander Poszler , Hayley Brown , Dirk Wilhelm , Roland M. Schmid , Stefan von Delius , Thomas Wittenberg

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.)



中文翻译:

结直肠中息肉的自动检测:一项前瞻性研究(带视频)

背景和目标

腺瘤检测是一项高度个性化的任务,内镜医师之间明显不同。因此,需要技术进步来改善腺瘤检出率(ADR)。自动化的计算机驱动技术将提供机会在结肠镜检查期间客观评估结肠直肠息肉的存在。我们在这里介绍了常规结肠镜检查条件下实时自动息肉检测软件(APDS)的应用。

方法

这是在德国一家大学医院进行的一项前瞻性研究。新型APDS(“ KoloPol”,Fraunhofer IIS,Erlangen,德国)的原型用于自动基于图像的息肉检测。该软件通过在实时结肠镜检查过程中以颜色编码突出可能的息肉病变的结构来运行。该研究的主要目标是在实时条件下测试APDS部署的可行性。APDS息肉检出率(PDR)被定义为次要终点,前提是内镜医师的检出为标准。

结果

将APDS应用于55例常规结肠镜检查,没有发生任何临床相关的不良事件。内镜医师的PDR和ADR分别为56.4%和30.9%。APDS的PDR和ADR分别为50.9%和29.1%。APDS检测到73例息肉中有55例(75.3%)。较小的息肉大小和扁平的息肉形态与APDS对息肉的检测不足有关。

结论

在实时结肠镜检查期间,计算机辅助的自动低延迟息肉检测是可行的。应努力改善扁平小息肉的APDS。(临床试验注册号:NCT02838888。)

更新日期:2018-10-17
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