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One-year review of real-time artificial intelligence (AI)-aided endoscopy performance

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Colonoscopies have long been the gold standard for detection of pre-malignant neoplastic lesions of the colon. Our previous study tried real-time artificial intelligence (AI)-aided colonoscopy over a three-month period and found significant improvements in collective and individual endoscopist’s adenoma detection rates compared to baseline. As an expansion, this study evaluates the 1-year performance of AI-aided colonoscopy in the same institution.

Methods

A prospective cohort study was conducted in a single institution in Singapore. The AI software used was GI Genius™ Intelligent Endoscopy Module, US-DG-2000309 © 2021 Medtronic. Between July 2021 and June 2022, polypectomy rates in non-AI-aided colonoscopies and AI-aided colonoscopies were calculated and compared. Some of the AI-aided colonoscopies were recorded and video reviewed. A “hit” was defined as a sustained detection of an area by the AI. If a polypectomy was performed for a “hit,” its histology was reviewed. Additional calculations for polyp detection rate (PDR), adenoma detection rate (ADR), and adenoma detection per colonoscopy (ADPC) were performed. Cost analysis was performed to determine cost effectiveness of subscription to the AI program.

Results

2433 AI-aided colonoscopies were performed between July 2021 and June 2022 and compared against 1770 non-AI-aided colonoscopies. AI-aided colonoscopies yielded significantly higher rates of polypectomies (33.6%) as compared with non-AI-aided colonoscopies (28.4%) (p < 0.001). Among the AI-aided colonoscopies, 1050 were reviewed and a final 843 were included for additional analysis. The polypectomy to “hit” ratio was 57.4%, PDR = 45.6%, ADR = 32.4%, and ADPC = 2.08. Histological review showed that 25 polyps (3.13%) were sessile-serrated adenomas. Cost analysis found that the increased polypectomy rates in AI-aided colonoscopes led to an increase in revenue, which covered the subscription cost with an excess of USD 20,000.

Conclusion

AI-aided colonoscopy is a cost effective means of improving colonoscopy quality and may help advance colorectal cancer screening in Singapore.

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Acknowledgements

G Khasthuri, SKH Endoscopy Center members (Fung-Joon Foo, Winson J. Tan, Sharmini S. Sivarajah, Leonard M. L. Ho, Jia-Lin Ng, Frederick H. Koh, Cheryl Chong, Darius Aw, Juinn-Haur Kam, Alvin YH Tan, Tousif Kabir, Choon-Chieh Tan, Baldwin P. M. Yeung, Wai-Keong Wong, Bin-Chet Toh, Lester WL Ong, Jason Barco, Hui-Wen Chua, Faith Leong, Christopher Kong, Cui-Li Lin, Eng-Kiong Teo, Yi-Kang Ng, Tze-Tong Tey, Marianne A. De-Roza, Jonathan Lum, Xiaoke Li, Jin-liang Li, Pei-Shi Goh, Nazeemah B. Mohd-Nor, Siok-Peng Ng).

Funding

No funding was provided for this study.

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Author notes

  1. Shuen-Ern Chin and Fang-Ting Wan have contributed equally to this work.

Authors and Affiliations

  1. Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore, 308232, Singapore

    Shuen-Ern Chin & Fang-Ting Wan

  2. Colorectal Service, Department of General Surgery, Sengkang General Hospital, SingHealth, 110 Sengkang East Way, Singapore, 544886, Singapore

    Jasmine Ladlad, Fung-Joon Foo & Frederick H. Koh

  3. Endoscopy Centre, Division of Hyperacute Care, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore

    Koy-Min Chue

  4. Department of Gastroenterology and Hepatology, Sengkang General Hospital, SingHealth, 110 Sengkang East Way, Singapore, 544886, Singapore

    Eng-Kiong Teo & Cui-Li Lin

Authors
  1. Shuen-Ern Chin
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  2. Fang-Ting Wan
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SKH Endoscopy Centre

Corresponding author

Correspondence to Frederick H. Koh.

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Disclosures

Dr Frederick H Koh is a Key-Opinion-Leader for Medtronic for AI in Endoscopy, Asia Pacific Region. Chin Shuen Ern, Wan Fang Ting, Dr Jasmine Ladlad, Dr Eng-Kiong Teo, Dr Cui-Li Lin, Dr Fung-Joon Foo and co-authors within SKH Endoscopy Center have no conflicts of interest or financial ties to disclose.

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Chin, SE., Wan, FT., Ladlad, J. et al. One-year review of real-time artificial intelligence (AI)-aided endoscopy performance. Surg Endosc 37, 6402–6407 (2023). https://doi.org/10.1007/s00464-023-09979-8

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  • DOI: https://doi.org/10.1007/s00464-023-09979-8

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