Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 16, 2021
Date Accepted: Jul 27, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Computer-aided diagnosis of diminutive colorectal polyps in endoscopic images: A systematic review and meta-analysis of diagnostic test accuracy
ABSTRACT
Background:
The majority of colorectal polyps are diminutive and benign, especially for those in the rectosigmoid colon, and resecting these polyps is not cost-effective. Advancements in image-enhanced endoscopy has improved the optical prediction of histology in colorectal polyps. However, subjective interpretability and inter-/intra-observer variability prohibited the widespread implementation. Studies on computer-aided diagnosis (CAD) are increasing; however, their small sample size limits the statistical significance.
Objective:
to evaluate the diagnostic test accuracy of CAD models in predicting the histology of diminutive colorectal polyps using endoscopic images.
Methods:
Core databases were searched for studies based on endoscopic imaging using CAD models for the histologic diagnosis of diminutive colorectal polyps and presenting data on diagnostic performance. Systematic review and diagnostic test accuracy meta-analysis were performed.
Results:
Overall, 13 studies were included. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD models for the diagnosis of diminutive colorectal polyps (adenomatous or neoplastic vs. nonadenomatous or nonneoplastic) were 0.96 (95% confidence interval, 0.93–0.97), 0.93 (0.91–0.95), 0.87 (0.76–0.93), and 87 (38–201), respectively. Meta-regression showed no heterogeneity, and no publication bias was detected. Subgroup analyses showed robust results. The negative predictive value of CAD models for the diagnosis of adenomatous polyp in the rectosigmoid colon was 0.96 (0.95–0.97), exceeding the threshold of the “diagnosis and leave” strategy.
Conclusions:
CAD models show potential for the optical histologic diagnosis of diminutive colorectal polyps using endoscopic images.
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