TY  - JOUR
AU  - Bang, Chang Seok
AU  - Lee, Jae Jun
AU  - Baik, Gwang Ho
PY  - 2021
DA  - 2021/8/25
TI  - Computer-Aided Diagnosis of Diminutive Colorectal Polyps in Endoscopic Images: Systematic Review and Meta-analysis of Diagnostic Test Accuracy
JO  - J Med Internet Res
SP  - e29682
VL  - 23
IS  - 8
KW  - artificial intelligence
KW  - deep learning
KW  - polyps
KW  - colon
KW  - colonoscopy
KW  - diminutive
AB  - Background: Most colorectal polyps are diminutive and benign, especially those in the rectosigmoid colon, and the resection of these polyps is not cost-effective. Advancements in image-enhanced endoscopy have improved the optical prediction of colorectal polyp histology. However, subjective interpretability and inter- and intraobserver variability prohibits widespread implementation. The number of studies on computer-aided diagnosis (CAD) is increasing; however, their small sample sizes limit statistical significance. Objective: This review aims to evaluate the diagnostic test accuracy of CAD models in predicting the histology of diminutive colorectal polyps by using endoscopic images. Methods: Core databases were searched for studies that were based on endoscopic imaging, used CAD models for the histologic diagnosis of diminutive colorectal polyps, and presented data on diagnostic performance. A 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% CI 0.93-0.97), 0.93 (95% CI 0.91-0.95), 0.87 (95% CI 0.76-0.93), and 87 (95% CI 38-201), respectively. The meta-regression analysis 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 polyps in the rectosigmoid colon was 0.96 (95% CI 0.95-0.97), and this value exceeded the threshold of the diagnosis and leave strategy. Conclusions: CAD models show potential for the optical histological diagnosis of diminutive colorectal polyps via the use of endoscopic images. Trial Registration: PROSPERO CRD42021232189; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=232189 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/8/e29682
UR  - https://doi.org/10.2196/29682
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34432643
DO  - 10.2196/29682
ID  - info:doi/10.2196/29682
ER  -