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Updated: May 3, 2026
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Computer-aided detection for computed tomographic colonography screening: a prospective comparison of a
Gabriella Iussich1, Loredana Correale, Carlo Senore
1From the *Radiology Unit, Institute for Cancer Research and Treatment, Candiolo; †im3D S.p.A., Torino; ‡AOU S Giovanni Battista, Torino; §Gastroenterology and Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome; and ∥Gastroenterology and Endoscopy Unit, Institute for Cancer Research and Treatment, Candiolo, Italy.
A new computer-aided detection (CAD) method improves adenoma detection rates similarly to traditional second-reader CAD but is more time-efficient. This first-reader CAD followed by a fast 2-dimensional review offers a valuable alternative for colonoscopy screening.
Area of Science:
- Medical Imaging
- Gastroenterology
- Artificial Intelligence in Medicine
Background:
- Fecal immunological tests identify patients needing colonoscopy.
- Computed tomographic colonography (CTC) is an alternative to colonoscopy.
- Computer-aided detection (CAD) can enhance diagnostic accuracy in medical imaging.
Purpose of the Study:
- To compare the diagnostic performance and time efficiency of two CAD paradigms.
- To evaluate a double-reading paradigm with first-reader CAD followed by a fast 2D review (DR FR-CAD).
- To compare DR FR-CAD with a double reading using second-reader CAD (SR CAD).
Main Methods:
- Prospective study of 182 patients undergoing CTC after positive fecal immunological tests.
- CTC studies were interpreted using unassisted reading, SR CAD, and DR FR-CAD in randomized order.
- Per-patient sensitivity and specificity for detecting 6-mm adenomas or larger were calculated, with colonoscopy as the reference standard.
Main Results:
- Sensitivity for detecting 6-mm adenomas or larger increased significantly with both SR CAD and DR FR-CAD compared to unassisted reading.
- No significant difference in sensitivity was found between SR CAD and DR FR-CAD.
- DR FR-CAD required less reading time than SR CAD and was only slightly longer than unassisted reading.
Conclusions:
- Double reading with first-reader CAD and fast 2D review improves adenoma detection rates to the level of second-reader CAD.
- This DR FR-CAD approach is more time-efficient than SR CAD.
- DR FR-CAD offers an effective alternative for enhancing adenoma detection in CTC.
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