Polyp detection and false-positive rates by computer-aided analysis of withdrawal-phase videos of colonoscopy of the right-sided colon segment in a randomized controlled trial comparing water exchange and air insufflation

Tang, Chia-Pei; Lin, Tu-Liang; Hsieh, Yu–Hsi; Hsieh, Chen-Hung; Tseng, Chih‐Wei; Leung, Felix W.

doi:10.1016/j.gie.2021.12.020

Cited by 7 publications

(8 citation statements)

References 52 publications

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“…In a study of video recordings of an RCT, artificial intelligence (computer‐aided detection) showed a significantly higher additional polyp detection rate and a lower number of false positives per colonoscopy (related to feces and bubbles) in the WE group compared with the air‐insufflation group. The analysis supported the hypothesis that the strengths of computer‐aided detection and WE complemented the weaknesses of each other in optimizing polyp detection 11 . The listing of WAC continued in the GIE Editorial Board top 10 topics: advances in GI endoscopy in 2020 12 .…”

Section: Discussionmentioning

confidence: 53%

“…The analysis supported the hypothesis that the strengths of computer-aided detection and WE complemented the weaknesses of each other in optimizing polyp detection. 11 The listing of WAC continued in the GIE Editorial Board top 10 topics: advances in GI endoscopy in 2020. 12 The use of on-demand sedation with WE reduced the insertion pain score, 13 lowered the dose of sedation medication, and shortened the recovery time.…”

Section: Discussionmentioning

confidence: 99%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

“…In this context, it is important to explore how WE could benefit screening colonoscopy practice during pandemic recovery. In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights 5–13 …”

Section: Introductionmentioning

confidence: 99%

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A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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Background and Aim: Endoscopy featured water-aided colonoscopy (WAC) as novel in the Innovation Forum in 2011. Gastrointestinal Endoscopy published a modified Delphi consensus review (MDCR) that supports WAC for clinical practice in 2021. We tested the hypothesis that experience was an important predictor of WAC use, either as water immersion (WI), water exchange (WE), or a combination of WI and WE. Methods: A questionnaire was sent by email to the MDCR authors with an in-depth knowledge of WAC. They responded and also invited colleagues and trainees without in-depth knowledge to respond. Logistic regression analysis was used with the reasons for WAC use treated as the primary outcome. Reports related to WAC post MDCR were identified. Results: Of 100 respondents, > 80% indicated willingness to adopt and modify practice to accommodate WAC. Higher adenoma detection rate (ADR) incentivized WE use. Procedure time slots ≤ 30 and > 30 min significantly predicted WI and WE use, respectively. Co-authors of the MDCR were significantly more likely to perform WAC (odds ratio [OR] = 7.5, P = 0.037). Unfamiliarity with (OR = 0.11, P = 0.02) and absence of good experience (OR = 0.019, P = 0.002) were associated with colonoscopists less likely to perform WAC. Reports related to WAC post MDCR revealed overall and right colon WE outcomes continued to improve. Network meta-analyses showed that WE was superior to Cap and Endocuff. On-demand sedation with WE shortened nursing recovery time. Conclusions: An important predictor of WAC use was experience. Superior outcomes continued to be reported with WE.* Kruskal-Wallis non-parametric test.CO 2 , carbon dioxide; WAC, water-aided colonoscopy; WE, water exchange colonoscopy; WI, water immersion colonoscopy.FW Leung et al.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

“…In the discussion, we will review the most recent WAC reports published after the cutoff date of literature search for the MDCR to add additional insights. [5][6][7][8][9][10][11][12][13]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Leung

Cadoni

Koo

et al. 2022

J of Gastro and Hepatol

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“…Recently, Tang et al 37 reported that the water exchange insertion method has the potential to reduce FP through salvage cleaning of feces and bubbles during insertion. However, we believe that, unlike endoscopic techniques, updating the system is a fundamental solution to FP and is directly related to the results.…”

Section: Discussionmentioning

confidence: 99%

Evaluating false‐positive detection in a computer‐aided detection system for colonoscopy

Okumura,

Imai,

Misawa

et al. 2024

J of Gastro and Hepatol

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Background and AimComputer‐aided detection (CADe) systems can efficiently detect polyps during colonoscopy. However, false‐positive (FP) activation is a major limitation of CADe. We aimed to compare the rate and causes of FP using CADe before and after an update designed to reduce FP.MethodsWe analyzed CADe‐assisted colonoscopy videos recorded between July 2022 and October 2022. The number and causes of FPs and excessive time spent by the endoscopist on FP (ET) were compared pre‐ and post‐update using 1:1 propensity score matching.ResultsDuring the study period, 191 colonoscopy videos (94 and 97 in the pre‐ and post‐update groups, respectively) were recorded. Propensity score matching resulted in 146 videos (73 in each group). The mean number of FPs and median ET per colonoscopy were significantly lower in the post‐update group than those in the pre‐update group (4.2 ± 3.7 vs 18.1 ± 11.1; P < 0.001 and 0 vs 16 s; P < 0.001, respectively). Mucosal tags, bubbles, and folds had the strongest association with decreased FP post‐update (pre‐update vs post‐update: 4.3 ± 3.6 vs 0.4 ± 0.8, 0.32 ± 0.70 vs 0.04 ± 0.20, and 8.6 ± 6.7 vs 1.6 ± 1.7, respectively). There was no significant decrease in the true positive rate (post‐update vs pre‐update: 95.0% vs 99.2%; P = 0.09) or the adenoma detection rate (post‐update vs pre‐update: 52.1% vs 49.3%; P = 0.87).ConclusionsThe updated CADe can reduce FP without impairing polyp detection. A reduction in FP may help relieve the burden on endoscopists.

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Artificial intelligence complemented by water exchange for right-sided colonic polyp detection: It’s time to dive!

Murino

Ahmad

2022

Gastrointestinal Endoscopy

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Polyp detection and false-positive rates by computer-aided analysis of withdrawal-phase videos of colonoscopy of the right-sided colon segment in a randomized controlled trial comparing water exchange and air insufflation

Cited by 7 publications

References 52 publications

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

A survey of colonoscopists with and without in‐depth knowledge of water‐aided colonoscopy

Evaluating false‐positive detection in a computer‐aided detection system for colonoscopy

Artificial intelligence complemented by water exchange for right-sided colonic polyp detection: It’s time to dive!

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