Artificial intelligence-assisted colonoscopy: A review of current state of practice and research

Abstract

Colonoscopy is an effective screening procedure in colorectal cancer prevention programs; however, colonoscopy practice can vary in terms of lesion detection, classification, and removal. Artificial intelligence (AI)-assisted decision support systems for endoscopy is an area of rapid research and development. The systems promise improved detection, classification, screening, and surveillance for colorectal polyps and cancer. Several recently developed applications for AI-assisted colonoscopy have shown promising results for the detection and classification of colorectal polyps and adenomas. However, their value for real-time application in clinical practice has yet to be determined owing to limitations in the design, validation, and testing of AI models under real-life clinical conditions. Despite these current limitations, ambitious attempts to expand the technology further by developing more complex systems capable of assisting and supporting the endoscopist throughout the entire colonoscopy examination, including polypectomy procedures, are at the concept stage. However, further work is required to address the barriers and challenges of AI integration into broader colonoscopy practice, to navigate the approval process from regulatory organizations and societies, and to support physicians and patients on their journey to accepting the technology by providing strong evidence of its accuracy and safety. This article takes a closer look at the current state of AI integration into the field of colonoscopy and offers suggestions for future research.

The effectiveness of real-time computer-aided and quality control systems in colorectal adenoma and polyp detection during colonoscopies: a meta-analysis

“…Taghiakbari et al . 30 found AI-assisted colonoscopies to have promising results in the detection of colorectal polyps and adenomas, however, the real-time application in clinical practice is not yet determined because the design, validation, and testing of AI models are underway. The largest ongoing AI-assisted clinical trial, PREEMPT CRC currently ongoing across the United States and the United Arab Emirates, will enroll 25,000 patients to screen for CRC among participants who are undergoing routine screening colonoscopies 31 .…”

A Review of the Technology, Training, and Assessment Methods for the First Real-Time AI-Enhanced Medical Device for Endoscopy

“…Colonoscopy procedures provide an excellent opportunity to develop advanced medical devices that utilize artificial intelligence (AI) [ 1 , 2 , 3 , 4 ]. This is primarily because physicians must analyze a large amount of information from a real-time video stream, often working under time constraints and facing repetitive tasks during extended periods.…”

Real-Time Computer-Aided Polyp and Adenoma Detection During Screening Colonoscopy In Expert And Non-Expert Endoscopists: A Single Center Study

“…The results were compared between experts and non-experts endoscopists. NCT04915833 1 2 3 4 5 6 (Fig. 2).…”