AI fails to improve detection of advanced neoplasms with colonoscopy

There were 3213 persons with a positive faecal immunochemical test. Researchers randomly assigned enrolled participants to colonoscopy with or without computer-aided detection. Advanced colorectal neoplasia was defined as advanced adenoma and advanced serrated polyp.

Key findings of this study are:

• The two groups had no significant difference in advanced colorectal neoplasia detection rate( 34.8 % for intervention and 34.6 % for control).
• The mean number of advanced colorectal neoplasias detected per colonoscopy with intervention and control was 0.54 and 0.52, respectively [aRR:1.04]
• There was no difference in the Adenoma detection rate for intervention and control, with 64.2% and 62.0%, respectively [aRR, 1.06].
• Computer-aided detection increased the mean number of nonpolypoid lesions, proximal adenomas, and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy.

Researchers said, “In our study, the high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates.”

They concluded that computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias.

Medtronic funded the study, as acknowledged.

Reference:

Mangas-Sanjuan C, de-Castro L, Cubiella J, Díez-Redondo P, Suárez A, Pellisé M, Fernández N, Zarraquiños S, Núñez-Rodríguez H, Álvarez-García V, Ortiz O, Sala-Miquel N, Zapater P, Jover R; CADILLAC study investigators. Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias : A Randomized Trial. Ann Intern Med. 2023 Sep;176(9):1145-1152. doi: 10.7326/M22-2619.