Artificial Intelligence–Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial

作者：Hong Xu, Raymond S. Tang, Thomas Y. Lam, Guijun Zhao, James Lau, Yunpeng Liu, Qi Wu, Long Rong, Weiran Xu, Xue Li, Sunny H. Wong, Shuntian Cai, Jing Wang, Guanyi Liu, Tantan Ma, Xiong Liang, Joyce Wing Yan Mak, Hongzhi Xu, Peng Yuan, Tingting Cao, Fudong Li, Zhenshi Ye, Zhang Shu-tian, Joseph J.�Y. Sung · 发表于：Clinical Gastroenterology and Hepatology · 年份：2022 · DOI：10.1016/j.cgh.2022.07.006 · 被引用次数：201 · 研究领域：Colorectal Cancer Screening and Detection、AI in cancer detection、COVID-19 diagnosis using AI

BACKGROUND AND AIMS: Artificial intelligence (AI)-assisted colonoscopy improves polyp detection and characterization in colonoscopy. However, data from large-scale multicenter randomized controlled trials (RCT) in an asymptomatic population are lacking. METHODS: This multicenter RCT aimed to compare AI-assisted colonoscopy with conventional colonoscopy for adenoma detection in an asymptomatic population. Asymptomatic subjects 45-75 years of age undergoing colorectal cancer screening by direct colonoscopy or fecal immunochemical test were recruited in 6 referral centers in Hong Kong, Jilin, Inner Mongolia, Xiamen, and Beijing. In the AI-assisted colonoscopy, an AI polyp detection system (Eagle-Eye) with real-time notification on the same monitor of the endoscopy system was used. The primary outcome was overall adenoma detection rate (ADR). Secondary outcomes were mean number of adenomas per colonoscopy, ADR according to endoscopist's experience, and colonoscopy withdrawal time. This study received Institutional Review Board approval (CRE-2019.393). RESULTS: From November 2019 to August 2021, 3059 subjects were randomized to AI-assisted colonoscopy (n = 1519) and conventional colonoscopy (n = 1540). Baseline characteristics and bowel preparation quality between the 2 groups were similar. The overall ADR (39.9% vs 32.4%; P < .001), advanced ADR (6.6% vs 4.9%; P = .041), ADR of expert (42.3% vs 32.8%; P < .001) and nonexpert endoscopists (37.5% vs 32.1%; P = .023), and adenomas p...