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Impact of Introducing Artificial Intelligence on Colonoscopy: A Retrospective Study on Potential Benefits and
Ayaka Takasu1,2, Hirofumi Kogure1, Zhehao Dai3
1Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Journal of Gastroenterology and Hepatology
|July 2, 2025
Summary
Computer-aided detection (CAD) significantly improved adenoma detection rates (ADRs) and polyp detection rates (PDRs) during colonoscopy. However, reliance on CAD may decrease endoscopist vigilance, necessitating careful integration into clinical practice.
Area of Science:
- Gastroenterology
- Medical Technology
- Endoscopy
Background:
- Computer-aided detection (CAD) systems aim to enhance adenoma detection rates (ADRs) during colonoscopy.
- The real-world impact of integrating CAD into routine colonoscopy practice remains incompletely understood.
- This study evaluates the effect of CAD introduction in a hospital setting.
Purpose of the Study:
- To assess the impact of introducing computer-aided detection (CAD) on colonoscopy outcomes.
- To compare adenoma detection rates (ADRs), polyp detection rates (PDRs), and sessile serrated lesion detection rates (SSLDRs) before and after CAD implementation.
- To evaluate endoscopist performance in detecting lesions with and without CAD assistance.
Main Methods:
- Retrospective analysis of 1314 colonoscopies performed between January and December 2023.
- Comparison of detection rates between a pre-intervention non-CAD group and a post-intervention CAD group.
- Evaluation of endoscopist performance by comparing pre-intervention non-CAD cases with post-intervention non-CAD cases.
Main Results:
- Adenoma detection rates (ADRs) were significantly higher with CAD (49.3%) compared to the pre-intervention non-CAD group (31.6%).
- Polyp detection rates (PDRs) were also significantly higher with CAD (57.9%) versus the pre-intervention non-CAD group (39.8%).
- Sessile serrated lesion detection rates (SSLDRs) were comparable between the CAD and pre-intervention non-CAD groups (4.4% vs. 2.8%).
- Post-intervention non-CAD group showed significantly lower ADRs (13.5%) and PDRs (18.2%) compared to the pre-intervention non-CAD group.
Conclusions:
- Introduction of CAD-assisted colonoscopy significantly enhances ADRs and PDRs.
- Potential over-reliance on CAD may lead to decreased endoscopist vigilance in independent lesion detection.
- Strategic implementation of CAD is crucial to maximize its clinical benefits while mitigating potential drawbacks.
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