The help of AI significantly improves colonoscopy Forty percent more polyps detected when the computer assists

A smart computer utilizing AI during an examination of the colon with a camera yields a forty percent increase in detected polyps, structures that can be precursors to cancer. This is evident from a publication by Radboud university medical center in The Lancet Digital Health. Previous research has already shown that detecting and removing more polyps leads to a reduction in colorectal cancer.

Annually, over 100,000 people in the Netherlands undergo a colonoscopy, an endoscopy of the colon. During this procedure, a doctor uses a camera to search for colorectal cancer and polyps, protrusions from the colon wall that can be precursors to colorectal cancer. Previous studies have shown that the more polyps a doctor finds and removes, the lower the likelihood of developing colorectal cancer later on.

Now, it appears that AI can significantly aid in this process. A doctor finds nearly forty percent more polyps when a smart computer assists in examining the camera images in the colon. ‘A doctor can miss polyps because they are just briefly in the image, or the attention is focused on another spot’, says medical researcher Michiel Maas. ‘But a computer examines every pixel in the image and is alert every millisecond. That provides significant added value.’

Purple square

This added value was demonstrated in a study involving almost 1000 patients, conducted in ten hospitals in different countries. Participants underwent a colonoscopy because they qualified for colorectal cancer screening or had previous polyps. They received either the standard colon examination or the examination where the computer live-monitored. The computer placed a purple square in the image if an area looked suspicious, drawing the doctor's attention for closer examination.

Although the computer helped detect and remove more polyps, the colonoscopy with digital assistance did not take more time. Additionally, the new procedure did not result in a higher percentage of false positives, i.e., tissue that was removed but later found non-threatening during analysis at the Pathology department. The additionally removed polyps were just as likely to be of a dangerous type as the polyps removed during a standard examination.

Harmless

The smart computer was developed by the company Magentiq Eye LTD. They trained the software to recognize abnormalities using thousands of photos and videos of colonoscopies from around the world. The system is now commercially available but is still limited in use. Maas: ‘This system costs money, and reimbursement for medical examinations with AI assistance is still in the development phase.’

In subsequent studies, researchers will investigate whether the computer can also determine the danger level of a polyp based on its visual characteristics and size. Professor and Gastroenterologist Peter Siersema mentioned: ‘If we can determine that during the examination, we can leave harmless polyps in place. You then don't need to analyze them in Pathology. Ultimately, this reduces the risk of complications and costs.’

About the publication

This study is published in The Lancet Digital Health: A novel computer-aided polyp detection system in screening and surveillance colonoscopy: an international multicentre, randomised, tandem trial. Michiel H.J. Maas, Helmut Neumann, Haim Shirin, Lior H. Katz, Ariel A. Benson, Arslan Kahloon, Elsa Soons, Rawi Hazzan, Marc J. Landsman, Benjamin Lebwohl, Suzanne K. Lewis, Visvakanth Sivanathan, Saowanee Ngamruengphong, Harold Jacob, Peter D. Siersema.

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