Computer-aided detection-assisted colonoscopy: classification and relevance of false positives

Post written by Matteo Badalamenti, MD, from the Humanitas Clinical and Research Center IRCCS, Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano, Milan.

The focus of our study was to define a structured classification of false-positive (FP) results provided by the Artificial Intelligence CADe system that was recently applied in endoscopic daily practice and to estimate their absolute and relative frequency, as well as their clinical relevance in a real-life scenario.

Artificial intelligence represents one of the most revolutionary turning points in the endoscopic daily practice. This CADe system is based on deep learning in which the computer learns to extend the provided algorithms and to create new ones without any human control. Thus, its outcome incorporates some unpredictability in the clinical setting that may hamper the efficiency of CADe-colonoscopy as a matter of additional time required to discriminate between actual false positives and true lesions as well as carrying a risk for unneeded resection.

Our study reported a high frequency of false-positive results (27.3 ± 13.1 per colonoscopy) not correlated to any clinical relevance in which no unneeded resections were performed and false-positive results observation only represented 0.7% of the mean withdrawal time. In the near future, we expect these CADe systems to improve even more in their specificity.


Supplementary Figure 1. Agreement on false positive trigger. (A) Fold, A.1; wizened fold, A.2; enlightened plica, A.3; margin of a plica, A.4; underwater fold. (B) Ileocecal valve: B.1, ileocecal valve opening; B.2, ileocecal valve; B.3, margin of the ileocecal valve; (C) appendicular foramen. (D) Normal mucosa: D.1, mucosal vasculature; D.2, Underwater mucosa; D.3, lens against mucosa. (E) Hemorrhoids: E.1, inflamed hemorrhoid; E.2, hemorrhoid; E.3, hemorrhoid, anterior view. (F) Abrasion. (G) Diverticula; (H) Suction; (I) Stools: I.1, stools; I.2, watery stools. (J) Mucus: J.1, mucus; J.2, watery mucus. (K) Bubbles: K.1, bubbles; K.2, bubble on lens. (L) Water: L.1, water; L.2, water jet. (M) bleeding.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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