Abstract：
OBJECTIVE: High-definition virtual chromoendoscopy, along with targeted biopsies, is recommended for dysplasia surveillance in ulcerative colitis patients at risk for colorectal cancer. Computer-aided detection (CADe) systems aim to improve colonic adenoma detection, however their efficacy in detecting polyps and adenomas in this context remains unclear. This study evaluates the CADe Discovery™ system\'s effectiveness in detecting colonic dysplasia in ulcerative colitis patients at risk for colorectal cancer.
METHODS: A prospective cross-sectional, non-inferiority, diagnostic test comparison study was conducted on ulcerative colitis patients undergoing colorectal cancer surveillance colonoscopy between January 2021 and April 2021. Patients underwent virtual chromoendoscopy (VCE) with iSCAN 1 and 3 with optical enhancement. One endoscopist, blinded to CADe Discovery™ system results, examined colon sections, while a second endoscopist concurrently reviewed CADe images. Suspicious areas detected by both techniques underwent resection. Proportions of dysplastic lesions and patients with dysplasia detected by VCE or CADe were calculated.
RESULTS: Fifty-two patients were included, and 48 lesions analyzed. VCE and CADe each detected 9 cases of dysplasia (21.4% and 20.0%, respectively; p=0.629) in 8 patients and 7 patients (15.4% vs. 13.5%, respectively; p=0.713). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for dysplasia detection using VCE or CADe were 90% and 90%, 13% and 5%, 21% and 2%, 83% and 67%, and 29.2% and 22.9%, respectively.
CONCLUSIONS: The CADe Discovery™ system shows similar diagnostic performance to VCE with iSCAN in detecting colonic dysplasia in ulcerative colitis patients at risk for colorectal cancer.
METHODS: A prospective cross-sectional, non-inferiority, diagnostic test comparison study was conducted on ulcerative colitis patients undergoing colorectal cancer surveillance colonoscopy between January 2021 and April 2021. Patients underwent virtual chromoendoscopy (VCE) with iSCAN 1 and 3 with optical enhancement. One endoscopist, blinded to CADe Discovery™ system results, examined colon sections, while a second endoscopist concurrently reviewed CADe images. Suspicious areas detected by both techniques underwent resection. Proportions of dysplastic lesions and patients with dysplasia detected by VCE or CADe were calculated.
RESULTS: Fifty-two patients were included, and 48 lesions analyzed. VCE and CADe each detected 9 cases of dysplasia (21.4% and 20.0%, respectively; p=0.629) in 8 patients and 7 patients (15.4% vs. 13.5%, respectively; p=0.713). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for dysplasia detection using VCE or CADe were 90% and 90%, 13% and 5%, 21% and 2%, 83% and 67%, and 29.2% and 22.9%, respectively.
CONCLUSIONS: The CADe Discovery™ system shows similar diagnostic performance to VCE with iSCAN in detecting colonic dysplasia in ulcerative colitis patients at risk for colorectal cancer.
摘要：
目的：高清虚拟色素内镜，以及有针对性的活检，建议用于有结直肠癌风险的溃疡性结肠炎患者的异型增生监测。计算机辅助检测（CADe）系统旨在改善结肠腺瘤的检测，然而，在这种情况下，它们在检测息肉和腺瘤方面的疗效尚不清楚。这项研究评估了CADeDiscoveryTM系统在检测有结直肠癌风险的溃疡性结肠炎患者结肠发育不良中的有效性。
方法：前瞻性横截面，非自卑，我们对2021年1月至2021年4月接受结直肠癌监测结肠镜检查的溃疡性结肠炎患者进行了诊断试验比较研究.患者接受了ISCAN1和3的虚拟色素内窥镜检查（VCE），并进行了光学增强。一个内窥镜医生,对CADeDiscoveryTM系统结果视而不见，检查的结肠切片，而第二位内窥镜医师同时检查了CADe图像。通过两种技术检测到的可疑区域进行了切除。计算通过VCE或CADe检测到的发育不良病变和发育不良患者的比例。
结果：纳入52例患者，并分析了48个病变。VCE和CADe各检出9例异型增生(21.4%和20.0%,分别为8例患者和7例患者（15.4%vs.13.5%,分别为；p=0.713）。灵敏度,特异性，阳性和阴性预测值，使用VCE或CADe进行发育不良检测的诊断准确性分别为90％和90％，13%和5%，21%和2%，83%和67%，和29.2%和22.9%，分别。
结论：在有结直肠癌风险的溃疡性结肠炎患者中，CADeDiscoveryTM系统在检测结肠异型增生方面显示出与使用iSCAN的VCE相似的诊断性能。
方法：前瞻性横截面，非自卑，我们对2021年1月至2021年4月接受结直肠癌监测结肠镜检查的溃疡性结肠炎患者进行了诊断试验比较研究.患者接受了ISCAN1和3的虚拟色素内窥镜检查（VCE），并进行了光学增强。一个内窥镜医生,对CADeDiscoveryTM系统结果视而不见，检查的结肠切片，而第二位内窥镜医师同时检查了CADe图像。通过两种技术检测到的可疑区域进行了切除。计算通过VCE或CADe检测到的发育不良病变和发育不良患者的比例。
结果：纳入52例患者，并分析了48个病变。VCE和CADe各检出9例异型增生(21.4%和20.0%,分别为8例患者和7例患者（15.4%vs.13.5%,分别为；p=0.713）。灵敏度,特异性，阳性和阴性预测值，使用VCE或CADe进行发育不良检测的诊断准确性分别为90％和90％，13%和5%，21%和2%，83%和67%，和29.2%和22.9%，分别。
结论：在有结直肠癌风险的溃疡性结肠炎患者中，CADeDiscoveryTM系统在检测结肠异型增生方面显示出与使用iSCAN的VCE相似的诊断性能。
