Clean Colon Software Program (CCSP), Proposal of a standardized Method to quantify Colon Cleansing During...

Area of Science:

• Gastroenterology
• Medical Imaging
• Software Development

Background:

• Inadequate bowel cleansing during colonoscopy can lead to missed neoplastic lesions.
• Current bowel preparation scales have limitations and lack standardization.
• An objective method to assess colon cleanliness during colonoscopy is needed.

Purpose of the Study:

• To develop a software algorithm for analyzing bowel cleansing during colonoscopies.
• To compare the software's performance against a validated bowel preparation scale.

Main Methods:

• A software application, the Clean Colon Software Program (CCSP), was developed.
• Fifty colonoscopy videos were recorded and divided into three segments.
• CCSP assigned a cleanliness score (0-3) to each segment before and after cleansing.
• Videos were also evaluated by four endoscopists using the Boston Bowel Preparation Scale.

Main Results:

• Colon cleansing showed a significant improvement of approximately 33.3% after lavage (P < 0.001).
• The right colon segment was significantly dirtier than the left colon segment pre-lavage.
• High interobserver agreement was found between endoscopists and the CCSP software (pre-cleansing: 0.87, post-cleansing: 0.86).

Conclusions:

• The developed software effectively distinguishes between clean and non-clean colon segments.
• The software's performance is comparable to expert endoscopist evaluations.
• This tool offers a standardized and objective method for assessing colon cleanliness.