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. 2025 Aug;39(8):5276-5286.
doi: 10.1007/s00464-025-11890-3. Epub 2025 Jun 30.

The implementation of computer-aided detection in an initial endoscopy training improves the quality measures of trainees' future colonoscopies: a retrospective cohort study

Zofia Orzeszko  1 , Tomasz Gach  2 , Sandra Necka  3 , Kajetan Ochwat  3 , Piotr Major  4 , Mirosław Szura  2
Affiliations

The implementation of computer-aided detection in an initial endoscopy training improves the quality measures of trainees' future colonoscopies: a retrospective cohort study

Zofia Orzeszko et al. Surg Endosc. 2025 Aug.

Abstract

Introduction: The implementation of computer-aided detection (CADe) systems has resulted in a growing number of young endoscopists being trained using AI-enhanced devices. The potential impact of AI-enhanced training on the trainees' future performance is undefined. This study aimed to evaluate the quality indicators of endoscopists trained in an AI environment compared to those trained conventionally.

Methods and procedure: In this retrospectively study, the independent performance of six endoscopists was evaluated after they had undergone initial training using either CADe (group A) or conventional endoscopy (group B: without CADe). Quality indicators and detection rates of laterally spreading tumors (LSTs) were compared between the two groups.

Results: A total of 6000 patients were included in the analysis. Groups were equal demographically and had similar cecal intubation rate. Withdrawal time (WT) was longer in the AI-trained group (mean difference 0.8 min; 95% confidence interval [CI]: 0.6-1.0). AI-trained group had also a significantly improved adenoma detection rate (ADR) by 5.3% (95% CI: 2.9-7.6%) and sessile lesion detection rate (SDR) by 5.4% (95% CI: 3.8-7.0%). AI-assisted training enhanced the detection of non-granular LSTs smaller than 20 mm by 0.2% (95% CI 0.1% to 0.4%) and was identified as a factor of high-quality performance in terms of ADR and SDR (OR 1.27, 95% CI: 1.14-1.42; OR 1.93, 95% CI: 1.10 to 3.37, respectively).

Conclusions: Endoscopists trained in colonoscopy using AI exceeded the aspirational targets of the quality guidelines when those trained conventionally achieved minimum quality measures.

Keywords: Adenoma detection rate (ADR); Artificial intelligence (AI); Computer-aided detection (CADe); Endoscopy training.

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Conflict of interest statement

Declarations. Disclosures: Zofia Orzeszko, Tomasz Gach, Kajetan Ochwat, Sandra Necka, Piotr Major, and Mirosław Szura have no disclosures. The study received no funding.

Figures

Fig. 1
Fig. 1
Study flow diagram. aCADe: computer-aided detection
Fig. 2
Fig. 2
A, B: Examples of CADe implementation in the target mode. Green boxes highlight polyps in real time during colonoscopy
Fig. 3
Fig. 3
Adenoma detection rate (ADRa) of each endoscopist (%)
Fig. 4
Fig. 4
Serrated lesions detection rate (SDRa) of each endoscopist (%)
Fig. 5
Fig. 5
Withdrawal time (WTa) of each endoscopist (min)
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424 - PubMed
    1. Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, Levin TR, Lieberman D, Robertson DJ (2017) Colorectal cancer screening: recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Gastroenterology 153:307–323 - PubMed
    1. Keswani RN, Crockett SD, Calderwood AH (2021) AGA clinical practice update on strategies to improve quality of screening and surveillance colonoscopy: expert review. Gastroenterology 161:701–711 - PubMed
    1. Kaminski MF, Thomas-Gibson S, Bugajski M, Bretthauer M, Rees CJ, Dekker E, Hoff G, Jover R, Suchanek S, Ferlitsch M, Anderson J, Roesch T, Hultcranz R, Racz I, Kuipers EJ, Garborg K, East JE, Rupinski M, Seip B, Bennett C, Senore C, Minozzi S, Bisschops R, Domagk D, Valori R, Spada C, Hassan C, Dinis-Ribeiro M, Rutter MD (2017) Performance measures for lower gastrointestinal endoscopy: a European society of gastrointestinal endoscopy (ESGE) quality improvement initiative. Endoscopy 49:378–397 - PubMed
    1. Bisschops R, East JE, Hassan C, Hazewinkel Y, Kamiński MF, Neumann H, Pellisé M, Antonelli G, Bustamante Balen M, Coron E, Cortas G, Iacucci M, Yuichi M, Longcroft-Wheaton G, Mouzyka S, Pilonis N, Puig I, van Hooft JE, Dekker E (2019) Advanced imaging for detection and differentiation of colorectal neoplasia: European society of gastrointestinal endoscopy (ESGE) guideline - update 2019. Endoscopy 51:1155–1179 - PubMed