Endoscopy and pathology: what the evidence shows
AI that flags possible polyps during colonoscopy, or suspicious tissue on digitized biopsy slides, for the physician to review.
Computer-aided detection (CADe) systems such as GI Genius and EndoScreener flag possible polyps on the colonoscopy video in real time for the endoscopist to confirm. A 2023 meta-analysis of 21 randomized trials (18,232 patients) found an adenoma detection rate of 44.0% with CADe versus 35.9% without, but no increase in detection of advanced adenomas and more removal of non-neoplastic polyps. A pragmatic implementation trial reported that CADe did not improve colonoscopists' performance. In a deskilling study at four centers in Poland that used another system, Olympus ENDO-AID, the adenoma detection rate in colonoscopies done without AI fell from 28.4% to 22.4% after AI was introduced.
In pathology, FDA authorized Paige Prostate in September 2021 as the first AI-based software designed to identify an area of interest on prostate biopsy images; in the supporting reader study, the software raised pathologists' average sensitivity for cancer on individual slide images by 7.3 percentage points, FDA said. Open questions include effects on patient-important outcomes, which the meta-analysis called unclear, and on endoscopists' own skills.
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General information, not medical advice. Every fact links to its source, and the page shows the date it was last reviewed.