一个计算机辅助系统提高了内镜师在检测结直肠多瘤方面的表现:一个多中心,随机对照试验
Heng Zhang1, Qi Wu2, Jing Sun3
1Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
计算机辅助检测 (CADe) 系统显著提高了结肠镜检测聚体的检测率,并减少了遗漏的聚体. 这种人工智能工具增强了内镜师的灵敏度,可能降低了结肠镜后结肠直肠癌 (CRC) 的风险.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 人工智能在医学中的应用
背景情况:
- 在结肠镜检查期间错过的结肠直肠多可能导致结肠镜检查后的结肠直肠癌 (CRC).
- 使用深度学习的计算机辅助检测 (CADe) 系统在增强多重体识别方面表现有前途.
- 评估CADe在临床结肠镜检查中的实际有效性至关重要.
研究的目的:
- 评估CADe系统对内镜师在结肠镜检查期间检测多的性能的影响.
- 为了确定CADe是否能在现实临床环境中提高灵敏度和特异性.
- 分析CADe对聚合体检测率 (PDR) 和错误检测率的影响.
主要方法:
- 一项随机对照试验,涉及1293名年龄在18-75岁的患者,遍及中国三个中心.
- 在1:1的比例下,患者被分配到以CADe辅助或无辅助 (对照) 的结肠镜.
- 主要结局包括内镜师的灵敏度和特异性;子组分析侧重于PDR和错误检测率.
主要成果:
- CADe显著增加了内镜敏感度 (84.97%与72.07%相比,p < 0.001),具有相似的特异性 (100.00%与100.00%).
- 在CADe系统改善了6-9毫米的息肉的PDR (18.04%对13.85%,p <0.05).
- 错误检测率与CADe显著降低,特别是在上午10:00至下午12:00之间 (12.5%与39.81%,p < 0.001).
结论:
- 该CADe系统显示了在结肠镜检查期间增强内镜师检测聚的敏感性的潜力.
- 实施CADe可能会导致遗漏的息肉减少,从而降低CRC的风险.
- 这种人工智能辅助的方法为改善结肠镜检查结果提供了宝贵的工具.
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