A Prospective Study to Evaluate the Performance of a Real-time System in the Estimation of Colorectal Polyp Size
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: EndoAIM.
- Who it may be relevant to
- Registry conditions: Colonic Polyps, CRC (Colorectal Cancer), Artificial Intelligence (AI). Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Hong Kong
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Colorectal polyp size is related to the risk of exhibiting advanced histological features. Moreover, polyps larger than 10 mm are associated with an elevated risk of metachronous advanced neoplasia and colorectal cancer (CRC). Consequently, accurate measurement of polyp size, especially at the 10 mm threshold is critical for risk stratification and surveillance intervals. Furthermore, polyp size is also important for the choice of the appropriate resection procedures. Underestimation may lead to delayed diagnosis, thereby increasing the risk of colorectal cancer, while overestimation may result in unnecessary surveillance endoscopies.
Detailed description
Concerns regarding polyp size measurement are increasing. In daily practice, polyp size is mostly estimated based on visual size estimation by the endoscopist, which has proven to be inaccurate, with reported accuracies ranging from 54% to 65%. Furthermore, a prevalent terminal digit preference has been observed, with clustering of size measurements at 5-mm intervals. Additionally, inappropriate surveillance recommendations based on endoscopists' visual assessment have been documented for up to 35% of polyps. Some endoscopists routinely use non-calibrated instruments such as biopsy forceps or polypectomy snares to improve polyp size estimation. However, this approach has proven to be costly and time-consuming. Besides, endoscopes' fisheye lens can lead to size distortions depending on placement of an instrument in the center or periphery of the endoscope image.
AI-assisted systems, such as Virtual Scale Endoscopy (Fujifilm, Tokyo, Japan) and ENDOANGEL-CPS (Renmin Hospital of Wuhan University, Wuhan, China), have been developed to increase the accuracy of polyp size measurement. However, these systems have primarily been tested in video-based studies, which may not accurately reflect real-time conditions. Recently, a new artificial intelligence system (EndoAIM) has been developed that allows polyp size measurement during real-time endoscopy. This system can automatically estimate the diameter of polyps. Preclinical studies have shown promising performance for EndoAIM, with an overall accuracy of 0.98 in discriminating polyp size at the 10 mm threshold. However, its measurement accuracy has not been tested in real patients during real-time endoscopy.
In this research project, we aim to evaluate the measurement accuracy of EndoAIM for estimating colorectal polyp size in real patients during real-time endoscopy.
Interventions
- Device EndoAIM
EndoAIM will be used during the withdrawal process of the colonoscopy
Primary outcome measures
- The primary endpoint is the difference in percentage for each measurement in discriminating polyp size at the 10mm threshold [Time frame: During the colonoscopy]
Secondary outcome measures (4)
- The percentage of correctness of each measurement in discriminating polyp size at the 5 mm threshold [Time frame: During the colonoscopy]
- The percentage of correct accuracy of measurement [Time frame: During the colonoscopy]
- Proportion of polyps [Time frame: During the colonoscopy]
- Proportion of subjects [Time frame: During the colonoscopy]
Eligibility criteria
Inclusion criteria
Subjects are eligible if:
- They have received colonoscopy for screening, surveillance or symptom investigation;
- Aged 18 years older or above;
- Written informed consent obtained.
Exclusion criteria
Subjects are excluded if they have:
- Contraindication to colonoscopy (e.g. intestinal obstruction or perforation)
- Contraindication or conditions precluding polyp resection (e.g. active gastrointestinal bleeding, uninterrupted anticoagulation or dual antiplatelets)
- Advanced comorbid conditions (defined as American Society of Anesthesiologists grade 4 or above)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Diagnostic
Study locations
Hong Kong · 1 center
- Prince of Wales Hospital — Shatin
Identifiers
NCT: NCT06957015 · 2024.608