Mode
Text Size
Log in / Sign up

CADe improves adenoma detection rate from 44% to 63% in standard-detector endoscopistsComputer tools may help some doctors find more colon polyps

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note that CADe improves adenoma detection in standard-detector endoscopists but increases withdrawal time and non-neoplastic resection.

This prospective study evaluated the impact of adding computer-aided detection (CADe) to Texture and Color Enhancement Imaging (TXI) during colonoscopy. The study included 263 patients, comparing a group using TXI and CADe (n=100) against a historical control group using TXI alone (n=163).

The primary outcome, adenoma detection rate (ADR), was 62% with TXI and CADe versus 55.8% with TXI alone (p = 0.33). However, for standard-detector endoscopists, the ADR improved from 44% to 63% when CADe was added (p = 0.046). The mean number of adenomas per colonoscopy remained similar between groups at 1.71 (p > 0.99).

Secondary outcomes showed that adding CADe led to an increase in the resection of non-neoplastic polyps from 16.6% to 27% (p = 0.042). Additionally, mean withdrawal time increased by almost 1-min with the addition of CADe (p < 0.001).

A primary limitation is the use of historical controls for comparison. While CADe showed benefit in a specific subgroup, it did not significantly change overall ADR. Clinicians should note that while CADe may assist less experienced endoscopists, it is associated with increased procedure time and higher rates of non-neoplastic polyp resection.

How this fits prior evidence

How this fits prior evidence: This finding extends the knowledge that computer-aided detection shows high sensitivity and specificity for detecting colorectal polyps of all sizes. It specifically addresses a gap by identifying that CADe may provide more significant benefits for standard-detector endoscopists, even when overall ADR improvements are not statistically significant.

Finding polyps during a colonoscopy is the first step in preventing colon cancer. Doctors often use special imaging to see these growths more clearly. This study looked at what happens when they add a computer-aided detection tool to that advanced imaging system.

Researchers compared two groups of doctors. One group used only the enhanced imaging, while the other used both the imaging and a computer-aided detection tool. For most doctors, adding the computer did not change how many polyps they found overall. However, for doctors who typically had lower detection rates, the computer tool significantly improved their ability to find adenomas (the type of growth that can become cancerous).

There are some trade-offs to consider. While the computer helped certain doctors find more polyps, it also led to a slight increase in the time spent withdrawing the scope. Additionally, doctors using the combined system were more likely to remove non-neoplastic polyps, which are growths that do not turn into cancer. Because this study compared current results to older data from a previous trial, the findings should be viewed with some caution.

What this means for you:
Computer tools can help less experienced doctors find more polyps but may increase procedure time and extra removals.

Common questions

Does the computer tool help all doctors find more polyps?

Not necessarily for everyone. While the overall adenoma detection rate did not show a significant difference between groups, it did improve specifically for endoscopists who had a lower starting detection rate of less than 55%.

Does using this technology make the procedure take longer?

Yes, there was a measurable increase in time. Doctors using both the enhanced imaging and the computer-aided tool saw an average increase of almost one minute in withdrawal time.

Are there any risks or downsides to using these tools?

One noted trade-off is that doctors using the combined system were more likely to remove non-neoplastic polyps, which are growths that do not become cancerous. You should talk to your doctor about the best technology for your specific needs.

Study Details

Study typeRct
Sample sizen = 263
EvidenceLevel 2
PublishedAug 2026
View Original Abstract ↓
OBJECTIVES: Early detection and resection of colorectal polyps prevent their progression toward advanced adenocarcinomas. The use of Texture and Color Enhancement Imaging (TXI) has been demonstrated to enhance adenoma detection compared to white light imaging. It remains unknown whether there is an additive benefit when using computer-aided detection (CADe) in addition to enhanced imaging technologies. METHODS: This prospective study involved the combined use of TXI and CADe during colonoscope withdrawal in the intervention group, compared against historical controls from a prior randomized controlled trial using TXI alone. The presence and number of colonic polyps identified, resected, and analyzed via histopathology were documented and compared between groups. RESULTS: A total of 263 patients were included in the analysis, 100 in the TXI and CADe group and 163 in the TXI-only group. There was no difference in the number of adenomas per colonoscopy (mean 1.71 in both groups, p > 0.99) or the adenoma detection rate (ADR) (62% with TXI and CADe vs. 55.8% with TXI alone, p = 0.33). In standard-detector endoscopists, there was an improvement in ADR using TXI and CADe compared with TXI alone (63% vs. 44%, p = 0.046). There was an almost 1-min increase in mean withdrawal time with TXI and CADe (p < 0.001) and an increase in the resection of non-neoplastic polyps (27% vs. 16.6%, p = 0.042). CONCLUSIONS: The addition of CADe did not impact overall adenoma detection, although it did improve adenoma detection in those with an ADR < 55%. This comes at the cost of increased withdrawal time and more frequent resection of non-neoplastic polyps. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12625000996460.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.