CC BY-NC-ND 4.0 · Endoscopy 2022; 54(10): 1009-1014
DOI: 10.1055/a-1770-7353
Innovations and brief communications

The influence of computer-aided polyp detection systems on reaction time for polyp detection and eye gaze

Joel Troya*
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Daniel Fitting*
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Boban Sudarevic
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Jakob Nikolas Kather
2   Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
,
Alexander Meining
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
› Author Affiliations
Supported by: Bavarian Center for Cancer Research (BZKF)
Supported by: Interdisziplinäres Zentrum für Klinische Forschung, Universitätsklinikum Würzburg F-406
Supported by: Funding cluster “Forum Gesundheitsstandort Baden-Württemberg” 5409.0-001.01/15


Abstract

Background Multiple computer-aided systems for polyp detection (CADe) have been introduced into clinical practice, with an unclear effect on examiner behavior. This study aimed to measure the influence of a CADe system on reaction time, mucosa misinterpretation, and changes in visual gaze pattern.

Methods Participants with variable levels of colonoscopy experience viewed video sequences (n = 29) while eye movement was tracked. Using a crossover design, videos were presented in two assessments, with and without CADe support. Reaction time for polyp detection and eye-tracking metrics were evaluated.

Results 21 participants performed 1218 experiments. CADe was significantly faster in detecting polyps compared with participants (median 1.16 seconds [99 %CI 0.40–3.43] vs. 2.97 seconds [99 %CI 2.53–3.77], respectively). However, the reaction time of participants when using CADe (median 2.90 seconds [99 %CI 2.55–3.38]) was similar to that without CADe. CADe increased misinterpretation of normal mucosa and reduced the eye travel distance.

Conclusions Results confirm that CADe systems detect polyps faster than humans. However, use of CADe did not improve human reaction times. It increased misinterpretation of normal mucosa and decreased the eye travel distance. Possible consequences of these findings might be prolonged examination time and deskilling.

* These authors contributed equally to this work.


Tables 1 s, 2 s; Figs. 1 s–4 s



Publication History

Received: 19 September 2021

Accepted: 10 February 2022

Accepted Manuscript online:
14 February 2022

Article published online:
31 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Corley DA, Jensen CD, Marks AR. et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-1306
  • 2 Kaminski MF, Robertson DJ, Senore C. et al. Optimizing the quality of colorectal cancer screening worldwide. Gastroenterology 2020; 158: 404-417
  • 3 Hassan C, Spadaccini M, Iannone A. et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc 2021; 93: 77-85
  • 4 Spadaccini M, Iannone A, Maselli R. et al. Computer-aided detection versus advanced imaging for detection of colorectal neoplasia: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 793-802
  • 5 Pfeifer L, Neufert C, Leppkes M. et al. Computer-aided detection of colorectal polyps using a newly generated deep convolutional neural network: from development to first clinical experience. Eur J Gastroenterol Hepatol 2021; 33: e662-e669
  • 6 Repici A, Badalamenti M, Maselli R. et al. Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Gastroenterology 2020; 159: 512-520
  • 7 Weigt J, Repici A, Antonelli G. et al. Performance of a new integrated computer-assisted system (CADe/CADx) for detection and characterization of colorectal neoplasia. Endoscopy 2022; 54: 180-184
  • 8 Hassan C, Wallace MB, Sharma P. et al. New artificial intelligence system: first validation study versus experienced endoscopists for colorectal polyp detection. Gut 2020; 69: 799-800
  • 9 Hassan C, Badalamenti M, Maselli R. et al. Computer-aided detection-assisted colonoscopy: classification and relevance of false positives. Gastrointest Endosc 2020; 92: 900-904
  • 10 Bisschops R, East JE, Hassan C. et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – update 2019. Endoscopy 2019; 51: 1155-1179
  • 11 Almansa C, Shahid MW, Heckman MG. et al. Association between visual gaze patterns and adenoma detection rate during colonoscopy: a preliminary investigation. Am J Gastroenterol 2011; 106: 1070-1074
  • 12 Lami M, Singh H, Dilley JH. et al. Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy. Endoscopy 2018; 50: 701-707
  • 13 Meining A, Atasoy S, Chung A. et al. “Eye-tracking” for assessment of image perception in gastrointestinal endoscopy with narrow-band imaging compared with white-light endoscopy. Endoscopy 2010; 42: 652-655
  • 14 Barclay RL, Vicari JJ, Doughty AS. et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med 2006; 355: 2533-2541