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Automated polyp detection in the colorectum: A prospective study (with videos)

: Klare, P.; Sander, C.; Prinzen, M.; Haller, B.; Nowack, S.; Abdelhafez, M.; Poszler, A.; Brown, H.; Wilhelm, D.; Schmid, R.M.; Delius, S. von; Wittenberg, T.


Gastrointestinal endoscopy 89 (2019), No.3, pp.576-582
ISSN: 0016-5107
ISSN: 1097-6779
Bundesministerium für Bildung und Forschung BMBF (Deutschland)
Journal Article
Fraunhofer IIS ()

Background and Aims: Adenoma detection is a highly personalized task that differs markedly among endoscopists. Technical advances are therefore desirable for the improvement of the adenoma detection rate (ADR). An automated computer-driven technology would offer the chance to objectively assess the presence of colorectal polyps during colonoscopy. We present here the application of a real-time automated polyp detection software (APDS) under routine colonoscopy conditions.
Methods: This was a prospective study at a university hospital in Germany. A prototype of a novel APDS ("KoloPol," Fraunhofer IIS, Erlangen, Germany) was used for automated image-based polyp detection. The software functions by highlighting structures of possible polyp lesions in a color-coded manner during real-time colonoscopy procedures. Testing the feasibility of APDS deployment under real-time conditions was the primary goal of the study. APDS polyp detection rates (PDRs) were defined as secondary endpoints provided that endoscopists' detection served as criterion standard.
Results: The APDS was applied in 55 routine colonoscopies without the occurrence of any clinically relevant adverse events. Endoscopists' PDRs and ADRs were 56.4% and 30.9%, respectively. The PDRs and ADRs of the APDS were 50.9% and 29.1%, respectively. The APDS detected 55 of 73 polyps (75.3%). Smaller polyp size and flat polyp morphology were correlated with insufficient polyp detection by the APDS.
Conclusion: Computer-assisted automated low-delay polyp detection is feasible during real-time colonoscopy. Efforts should be undertaken to improve the APDS with respect to smaller and flat shaped polyps.