Computer-aided diagnosis for optical diagnosis of diminutive colorectal polyps including sessile serrated lesions: a real-time comparison with screening endoscopists

Background: In this study, we aimed to compare the accuracy for optical diagnosis of diminutive colorectal polyps between a CADx system (POLAR system) and endoscopists during real-time colonoscopy, including sessile serrated lesions (SSLs). Patients and methods: We developed the POLAR system, capable of performing real-time characterization of diminutive colorectal polyps. For pre-training, the Microsoft-COCO dataset with non-polyp object images (300k) was used. For training, 8 hospitals prospectively collected 2.637 annotated images from 1.339 polyps (i.e. new publicly available POLAR database). For clinical validation, POLAR was tested during colonoscopy in fecal immunochemical test (FIT)-positive individuals, and compared with the performance of 20 endoscopists from 8 hospitals. Endoscopists were blinded to the POLAR outcome. Primary outcome was the comparison of accuracy in the optical diagnosis of diminutive colorectal polyps between POLAR and endoscopists (neoplastic [adenomas and SSLs] vs non-neoplastic [hyperplastic polyps]). Histopathology served as the reference standard. Results: During clinical validation, a total of 423 diminutive polyps detected in 194 FIT-positive individuals were included for analysis (300 adenomas, 41 SSLs, 82 hyperplastic polyps). POLAR distinguished neoplastic from non-neoplastic lesions with 79% accuracy, 89% sensitivity and 38% specificity. The endoscopists achieved 83% accuracy, 92% sensitivity, and 44% specificity. The optical diagnosis accuracy between POLAR and endoscopists was not significantly different (P=.10). The success rate for acquiring a histological prediction by POLAR was 98%. Conclusions: We have developed a CADx system that differentiated neoplastic from non-neoplastic diminutive polyps during endoscopy with an accuracy comparable to the accuracy of screening endoscopists, with near-perfect technical efficacy.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Computer-aided diagnosis for optical diagnosis of diminutive colorectal polyps including sessile serrated lesions: a real-time comparison with screening endoscopists ; day:09 ; month:01 ; year:2023 ; Endoscopy ; (09.01.2023)

Contributors, Places and Time

• Contributor: Houwen, Britt B.S.L. ; Hazewinkel, Yark ; Giotis, Ioannis ; Vleugels, Jasper L.A. ; Mostafavi, Nahid ; van Putten, Paul ; Fockens, Paul ; Dekker, Evelien

Further information

• DOI: 10.1055/a-2009-3990
• URN: urn:nbn:de:101:1-2023022310304244468342
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:45 AM CEST