ArticleClinical and translational gastroenterology2026
Effect of Combination of a Mucosal Exposure Device and Computer-Aided Detection in Diagnostic, Screening, and Surveillance Colonoscopy: An International, Multicenter Study.
Article in Clinical and translational gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMucosal exposure devices (MEDs) and computer-aided detection (CADe) systems may both improve adenoma detection through distinct mechanisms: expanding mucosal visualization and highlighting lesions, respectively. This study investigated the efficacy of combining CADe-assisted colonoscopy with a MED compared with CADe-assisted colonoscopy alone.
methodsThis international, multicenter, prospective, nonrandomized, single-arm study (NTC05220345) was conducted at 3 centers that also participated in the previous DISCOVERY II randomized controlled trial, comparing CADe-assisted with conventional colonoscopy. Eligible participants were patients referred for diagnostic, nonfecal immunochemical test screening, or surveillance colonoscopy and underwent CADe-assisted colonoscopy (DISCOVERY, PENTAX Medical) with a MED using an integrated inflatable balloon (G-EYE, SMART Medical Systems). The primary outcome was adenoma detection rate (ADR); secondary outcomes included sessile serrated lesion detection rate and withdrawal time without interventions. Outcomes were compared with historical controls of the CADe-arm of the DISCOVERY II study.
resultsOf 196 enrolled participants, 182 were included in the final analysis and compared with 250 participants from the historical CADe-arm. ADR was 47.3% in the CADe + MED-group vs 38.4% in the CADe-group ( P = .066; absolute difference: 8.9%, 95% confidence interval: 0.6-18.3). Mixed-effects logistic regression model adjusting for clustering and confounders calculated an odds ratio of 1.16 (95% confidence interval: 0.74-1.81). Median withdrawal time was slightly longer with CADe + MED compared with CADe-only (10.0 vs 9.2 minutes, P = 0.004), whereas sessile serrated lesion detection rate was not significantly different (12.6% vs 18.4%, P = 0.11). DISCUSSION: In this study using historical controls, CADe-assisted colonoscopy combined with a MED did not significantly increase ADR compared with CADe alone, suggesting limited synergistic benefit.
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