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在查和监测结肠镜中使用计算机辅助的多检测系统:一个国际,多中心,随机,并联试验

Michiel H J Maas¹, Helmut Neumann², Haim Shirin³

¹Department of Gastroenterology & Hepatology, Radboud University Medical Center, Nijmegen, Netherlands.

The Lancet. Digital health

|February 23, 2024

概括

计算机辅助检测 (CAD) 在结肠镜检查期间显著提高了腺瘤检测率. 这项技术还减少了遗漏的腺瘤,提高了查和监测的有效性,而不会增加非腺瘤切除.

科学领域:

胃肠病学胃肠病学
医疗成像医学成像
临床试验临床试验

背景情况:

关于日常结肠镜查和监测中的计算机辅助检测 (CAD) 的研究有限.
在这种临床环境中评估一种新的CAD系统至关重要.

研究的目的:

评估一项新的计算机辅助检测 (CAD) 系统在结肠镜中的有效性.
在查和监测方面,将CAD辅助结肠镜与传统结肠镜进行比较.

主要方法:

一个多中心,随机对照试验,涉及欧洲,美国和以色列31名内镜医生.
接受查或监视结肠镜检查的患者被随机分配到CAD辅助或常规结肠镜检查中.
一个子组接受了双重结肠镜检查,以评估腺瘤遗漏率.

主要成果:

计算机辅助检测 (CAD) 显著增加了每次结肠镜检查中的腺瘤 (0.70对0.51,p=0.015).
每次提取的腺瘤 (APE) 与CAD显示非劣势 (0.59与0.66,p<0.001非劣势).
在CAD-first组中,腺瘤错误率明显较低 (19%对36%,p=0.024).

结论:

计算机辅助检测 (CAD) 在查和监测结肠镜检查期间增强了腺瘤检测.
与传统结肠镜相比,CAD系统可以降低腺瘤错误率.
使用CAD并没有导致非腺瘤性病变的切除增加.

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