人工智能辅助的结肠镜检测多重体:一个系统的审查和元分析
Saeed Soleymanjahi1, Jack Huebner2, Lina Elmansy2
1Division of Gastroenterology, Mass General Brigham, Harvard School of Medicine, Boston, Massachusetts (S.Soleymanjahi).
Annals of internal medicine
|November 12, 2024
概括
计算机辅助检测 (CADe) 增强结肠镜增加了腺瘤检测,但与传统方法相比,在高级结肠直肠瘤 (ACN) 检测方面没有显著差异. CADe系统可提高每次结肠镜检查的腺瘤检测率,对手术时间的影响最小.
科学领域:
- 胃肠病学 胃肠病学
- 医疗技术 医疗技术 医学技术
- 内镜检查是指内镜检查.
背景情况:
- 随机临床试验 (RCT) 将计算机辅助检测 (CADe) 系统增强结肠镜与传统结肠镜进行比较,表明腺瘤检测率 (ADR) 改善,腺瘤错误率 (AMR) 降低.
- 然而,CADe增强结肠镜对检测晚期结肠直肠瘤 (ACN) 的影响尚不清楚.
研究的目的:
- 系统地审查和比较CADe增强结肠镜与传统结肠镜的性能.
- 该审查旨在澄清CADe系统在检测结直肠瘤方面的有效性.
主要方法:
- 在多个数据库 (Cochrane Library,Google Scholar,EMBASE,MEDLINE,PubMed,Scopus,Web of Science) 进行了系统的搜索,一直持续到2024年2月.
- 包括的研究包括已发表的RCT,比较了CADe增强和常规结肠镜.
- 主要结局包括每次结肠镜检查的平均腺瘤 (APC) 和每次结肠镜检查的ACN;次要结局是ADR,AMR和ACN检测率 (ACN DR).
主要成果:
- 分析了44个涉及36,201名患者的RCT.
- 与传统结肠镜相比,CADe增强结肠镜显示出更高的APC (0.98对0.78) 和ADR (44.7%对36.7%).
- 虽然每次结肠镜检查的平均ACN相似 (0.16对0.15),但ACN检测率 (ACN DR) 与CADe (12.7%对11.5%) 显著更高.
- CADe的使用导致非新发性息肉切除和总停药时间略有增加.
结论:
- 增强CADe结肠镜显著增加了腺瘤检测率.
- 该技术在检测晚期结肠直肠瘤时没有显著差异,尽管检测率略有提高.
- 性能估计可能受到研究异质性和无法盲目的内镜师的影响.
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