Evaluation of novel LCI CAD EYE system for real time detection of colon polyps

Abstract

Background: Linked color imaging (LCI) has been shown to be effective in multiple randomized controlled trials for enhanced colorectal polyp detection. Recently, artificial intelligence (AI) with deep learning through convolutional neural networks has dramatically improved and is increasingly recognized as a promising new technique for enhancing colorectal polyp detection.

Aim: This study aims to evaluate a newly developed computer-aided detection (CAD) system in combination with LCI for colorectal polyp detection.

Methods: First, a convolutional neural network was trained for colorectal polyp detection in combination with the LCI technique using a dataset of anonymized endoscopy videos. For validation, 240 polyps within fully recorded endoscopy videos in LCI mode, covering the entire spectrum of adenomatous histology, were used. Sensitivity (true-positive rate per lesion) and false-positive frames in a full procedure were assessed.

Results: The new CAD system used in LCI mode could process at least 60 frames per second, allowing for real-time video analysis. Sensitivity (true-positive rate per lesion) was 100%, with no lesion being missed. The calculated false-positive frame rate was 0.001%. Among the 240 polyps, 34 were sessile serrated lesions. The detection rate for sessile serrated lesions with the CAD system used in LCI mode was 100%.

Conclusions: The new CAD system used in LCI mode achieved a 100% sensitivity per lesion and a negligible false-positive frame rate. Note that the new CAD system used in LCI mode also specifically allowed for detection of serrated lesions in all cases. Accordingly, the AI algorithm introduced here for the first time has the potential to dramatically improve the quality of colonoscopy.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. The AI system highlights the polyp by placing a colored box around it.

In addition, the detection is accompanied by a specific sound. Here, the polyp is located in the central portion of the endoscopic image. Therefore, the specific visual assist circle is not activated compared with the polyp in Fig 2.

Fig 2. The specific graphic user interphase of the CAD EYE system also highlights the direction in which the polyp has been detected.

Here, the polyp is directly located behind one colonic fold of the ascending colon and might therefore be easily missed. The full-length sequence is available in the S1 Video, especially highlighting the position of the polyp in the ascending colon.