Klare, P.P.KlareSander, C.C.SanderPrinzen, M.M.PrinzenHaller, B.B.HallerNowack, S.S.NowackAbdelhafez, M.M.AbdelhafezPoszler, A.A.PoszlerBrown, H.H.BrownWilhelm, D.D.WilhelmSchmid, R.M.R.M.SchmidDelius, S. vonS. vonDeliusWittenberg, T.T.Wittenberg2022-03-052022-03-052019https://publica.fraunhofer.de/handle/publica/25825010.1016/j.gie.2018.09.042Background 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.en621616006journal article