Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.07.005
Shanshan Wang MD, Bo Shen MD
Ulcerative colitis (UC)-associated strictures, although infrequent, are complex to treat and often prompt surgical resection as a result of concerns about underlying malignancy. However, benign strictures resulting from the inflammation-induced fibrosis represent an important and underaddressed clinical scenario. Although endoscopic stricture therapy is well-established in Crohn’s disease–associated strictures, its use in UC has not been described in the literature, to our knowledge. We report a case of a benign colonic stricture in a UC patient after a severe flare who achieved clinical remission with vedolizumab. Endoscopic stricturotomy was performed, resulting in sustained luminal patency over a 2-year follow-up period. Serial biopsies showed no dysplasia. The patient remained in clinical and endoscopic remission. This case suggests that combined medical and endoscopic therapy may promote the resolution of UC-associated benign strictures.
{"title":"Resolution of severe ulcerative colitis–associated benign stricture with combined vedolizumab and endoscopic stricturotomy: a case report","authors":"Shanshan Wang MD, Bo Shen MD","doi":"10.1016/j.igie.2025.07.005","DOIUrl":"10.1016/j.igie.2025.07.005","url":null,"abstract":"<div><div>Ulcerative colitis (UC)-associated strictures, although infrequent, are complex to treat and often prompt surgical resection as a result of concerns about underlying malignancy. However, benign strictures resulting from the inflammation-induced fibrosis represent an important and underaddressed clinical scenario. Although endoscopic stricture therapy is well-established in Crohn’s disease–associated strictures, its use in UC has not been described in the literature, to our knowledge. We report a case of a benign colonic stricture in a UC patient after a severe flare who achieved clinical remission with vedolizumab. Endoscopic stricturotomy was performed, resulting in sustained luminal patency over a 2-year follow-up period. Serial biopsies showed no dysplasia. The patient remained in clinical and endoscopic remission. This case suggests that combined medical and endoscopic therapy may promote the resolution of UC-associated benign strictures.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 355-358"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.07.004
George M. Wahba MD, Gene K. Liaw PA-C, Emmanuel Coronel MD, Jeffrey H. Lee MD, Phillip S. Ge MD
{"title":"Use of a novel therapeutic endoscope with expanded retroflexion angles for endoscopic submucosal dissection","authors":"George M. Wahba MD, Gene K. Liaw PA-C, Emmanuel Coronel MD, Jeffrey H. Lee MD, Phillip S. Ge MD","doi":"10.1016/j.igie.2025.07.004","DOIUrl":"10.1016/j.igie.2025.07.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 351-352"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.09.008
Kimberly F. Schuster MD, MBA , Alexandra Goad BM , Steven N. Steinway MD, PhD
Background and Aims
Detecting postprocedural bleeding (PPB) after high-risk endoscopic interventions remains challenging. A fixed intraluminal bleeding sensor could improve PPB detection.
Methods
This case series included patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) who were monitored for 24 to 48 hours by affixing a capsule-based bleeding sensor to the duodenal wall.
Results
Five patients underwent ERCP with sphincterotomy (n = 3) or ampullectomy (n = 2). The sensor was positive in 3 and negative in 2. Repeat endoscopy confirmed bleeding in 2 sensor-positive cases and 1 sensor-negative case, and hemostasis was successfully achieved. Sensor migration occurred in 3 cases. One patient with persistently negative readings was safely discharged. No adverse events occurred over 3 to 6 months of follow-up.
Conclusions
This pilot series supports the feasibility of a fixed capsule–based sensor for real-time PPB detection as an adjunct to standard monitoring. Larger studies are needed to validate effectiveness and optimize deployment.
{"title":"An affixed, ingestible blood-sensing monitor for continuous monitoring after high-risk endoscopic procedures: a case series","authors":"Kimberly F. Schuster MD, MBA , Alexandra Goad BM , Steven N. Steinway MD, PhD","doi":"10.1016/j.igie.2025.09.008","DOIUrl":"10.1016/j.igie.2025.09.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Detecting postprocedural bleeding (PPB) after high-risk endoscopic interventions remains challenging. A fixed intraluminal bleeding sensor could improve PPB detection.</div></div><div><h3>Methods</h3><div>This case series included patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) who were monitored for 24 to 48 hours by affixing a capsule-based bleeding sensor to the duodenal wall.</div></div><div><h3>Results</h3><div>Five patients underwent ERCP with sphincterotomy (n = 3) or ampullectomy (n = 2). The sensor was positive in 3 and negative in 2. Repeat endoscopy confirmed bleeding in 2 sensor-positive cases and 1 sensor-negative case, and hemostasis was successfully achieved. Sensor migration occurred in 3 cases. One patient with persistently negative readings was safely discharged. No adverse events occurred over 3 to 6 months of follow-up.</div></div><div><h3>Conclusions</h3><div>This pilot series supports the feasibility of a fixed capsule–based sensor for real-time PPB detection as an adjunct to standard monitoring. Larger studies are needed to validate effectiveness and optimize deployment.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 365-368"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.08.005
Pierce L. Claassen MD , Dustene L. Johnston MSN, RN , Benjamin J. Adkins MD , Nancy B. Panko MD , John S. Visger MD
Background and Aims
Disproportionate increases in colorectal cancer (CRC) morbidity and mortality have been documented in rural communities, even when adjusted for race, ethnicity, and socioeconomic status. The American Society for Gastrointestinal Endoscopy recently updated colonoscopy standards by increasing adenoma detection rate (ADR) and withdrawal time (WT) recommendations. Computer-aided detection (CADe) is believed to increase ADR by a magnitude of 14.4%. Studies examining how CADe affects ADR, polyp detection rate (PDR), and WT among nongastroenterology fellowship–trained endoscopists in rural areas are absent. Our study aims to assess changes in ADR of 2 general surgeons (GSs) and 1 family medicine (FM) physician with the use of CADe in a remote Critical Access Hospital (Pullman Regional Hospital in Pullman, Wash, USA).
Methods
Adults undergoing colonoscopy for the indication of CRC screening or surveillance were eligible. Patients with inadequate bowel preparation or those where the procedure was not completed were excluded from analysis. CADe was used strictly during colonoscope withdrawal. Only histologically validated adenomas were included in ADR calculations.
Results
In total, 1128 colonoscopies occurred prior and 1644 after implementing CADe. The mean age was 56.66 years; 51.96% were female. With CADe, average group WT was greater than 10 minutes, and ADR increased from 30.13% to 35.77% (P = .0245) and PDR from 45.11% to 50.00% (P = .0703). Groupwide ADR and PDR percentages increased by a relative magnitude of 18.71% and 10.83% above baseline, respectively.
Conclusions
CADe resulted in improved ADR, greater than historically published. Former studies were primarily done at large centers with fellows or board-certified gastroenterologists. Disparities in CRC screening may be addressed in rural regions by using CADe technology.
{"title":"A retrospective cohort study evaluating the impact of computer-aided detection on adenoma and polyp detection rates among nongastroenterologist endoscopists in a rural medical center","authors":"Pierce L. Claassen MD , Dustene L. Johnston MSN, RN , Benjamin J. Adkins MD , Nancy B. Panko MD , John S. Visger MD","doi":"10.1016/j.igie.2025.08.005","DOIUrl":"10.1016/j.igie.2025.08.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Disproportionate increases in colorectal cancer (CRC) morbidity and mortality have been documented in rural communities, even when adjusted for race, ethnicity, and socioeconomic status. The American Society for Gastrointestinal Endoscopy recently updated colonoscopy standards by increasing adenoma detection rate (ADR) and withdrawal time (WT) recommendations. Computer-aided detection (CADe) is believed to increase ADR by a magnitude of 14.4%. Studies examining how CADe affects ADR, polyp detection rate (PDR), and WT among nongastroenterology fellowship–trained endoscopists in rural areas are absent. Our study aims to assess changes in ADR of 2 general surgeons (GSs) and 1 family medicine (FM) physician with the use of CADe in a remote Critical Access Hospital (Pullman Regional Hospital in Pullman, Wash, USA).</div></div><div><h3>Methods</h3><div>Adults undergoing colonoscopy for the indication of CRC screening or surveillance were eligible. Patients with inadequate bowel preparation or those where the procedure was not completed were excluded from analysis. CADe was used strictly during colonoscope withdrawal. Only histologically validated adenomas were included in ADR calculations.</div></div><div><h3>Results</h3><div>In total, 1128 colonoscopies occurred prior and 1644 after implementing CADe. The mean age was 56.66 years; 51.96% were female. With CADe, average group WT was greater than 10 minutes, and ADR increased from 30.13% to 35.77% (<em>P</em> = .0245) and PDR from 45.11% to 50.00% (<em>P</em> = .0703). Groupwide ADR and PDR percentages increased by a relative magnitude of 18.71% and 10.83% above baseline, respectively.</div></div><div><h3>Conclusions</h3><div>CADe resulted in improved ADR, greater than historically published. Former studies were primarily done at large centers with fellows or board-certified gastroenterologists. Disparities in CRC screening may be addressed in rural regions by using CADe technology.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 318-321"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.09.013
Linda S. Lee MD , Jay Caplan BS, MBA , Harith Rajagopalan MD, PhD
{"title":"A moonshot for diabetes and obesity","authors":"Linda S. Lee MD , Jay Caplan BS, MBA , Harith Rajagopalan MD, PhD","doi":"10.1016/j.igie.2025.09.013","DOIUrl":"10.1016/j.igie.2025.09.013","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 384-389"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.08.006
Michael Bejjani MD , Farimah Fayyaz MD , Divya Rayapati MD , Michel Almardini MD , Romina Roshanshad MD , Manol Jovani MD, MPH , Mouen A. Khashab MD
Background and Aims
Peroral endoscopic myotomy with fundoplication (POEM-F) is a novel procedure that provides a preventative interventional option to reduce rates of post-POEM gastroesophageal reflux disease (GERD) via anterior myotomy followed by a partial anterior wrap. Defining the learning curve (LC) is necessary to create adequate subspecialty training programs and quality assurance.
Methods
This study is a retrospective analysis of a prospectively maintained data set of patients who underwent POEM-F at a single tertiary referral center. The primary outcome was the LC for POEM-F, defined by the number of cases needed to achieve proficiency and mastery, assessed using cumulative sum analysis. Sequential time-block analysis also was performed.
Results
Thirty-one consecutive patients underwent POEM-F. The same endoscopist performed all procedures using the same technique. Technical success was achieved in 96.8% and clinical success (Eckardt score <3) in 100% of patients. The mean (standard deviation) total procedural and fundoplication alone times were 93.8 (19.6) minutes and 55.5 (18.2) minutes, respectively. Over a median follow-up of 14 weeks, the mean Eckardt score decreased from 7.3 to 0.3. At follow-up, Los Angeles reflux esophagitis of grades B, C, and D was observed in 2 patients (10.5%), 1 (5.3%), and none, respectively. There was only 1 postprocedural adverse event, graded as mild and successfully treated conservatively. Evaluation of the cumulative sum curve using the fundoplication time revealed that 17 cases were needed to achieve proficiency and 19 cases to achieve mastery. These results were confirmed with sequential time-block analysis.
Conclusions
We report data on the LC for POEM-F. Approximately 17 procedures may be the threshold to achieve proficiency, and approximately 19 cases to master the technique, although larger studies with more endoscopists, both experts and novices, are required.
{"title":"Assessment of the learning curve for peroral endoscopic myotomy with fundoplication for a single operator","authors":"Michael Bejjani MD , Farimah Fayyaz MD , Divya Rayapati MD , Michel Almardini MD , Romina Roshanshad MD , Manol Jovani MD, MPH , Mouen A. Khashab MD","doi":"10.1016/j.igie.2025.08.006","DOIUrl":"10.1016/j.igie.2025.08.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Peroral endoscopic myotomy with fundoplication (POEM-F) is a novel procedure that provides a preventative interventional option to reduce rates of post-POEM gastroesophageal reflux disease (GERD) via anterior myotomy followed by a partial anterior wrap. Defining the learning curve (LC) is necessary to create adequate subspecialty training programs and quality assurance.</div></div><div><h3>Methods</h3><div>This study is a retrospective analysis of a prospectively maintained data set of patients who underwent POEM-F at a single tertiary referral center. The primary outcome was the LC for POEM-F, defined by the number of cases needed to achieve proficiency and mastery, assessed using cumulative sum analysis. Sequential time-block analysis also was performed.</div></div><div><h3>Results</h3><div>Thirty-one consecutive patients underwent POEM-F. The same endoscopist performed all procedures using the same technique. Technical success was achieved in 96.8% and clinical success (Eckardt score <3) in 100% of patients. The mean (standard deviation) total procedural and fundoplication alone times were 93.8 (19.6) minutes and 55.5 (18.2) minutes, respectively. Over a median follow-up of 14 weeks, the mean Eckardt score decreased from 7.3 to 0.3. At follow-up, Los Angeles reflux esophagitis of grades B, C, and D was observed in 2 patients (10.5%), 1 (5.3%), and none, respectively. There was only 1 postprocedural adverse event, graded as mild and successfully treated conservatively. Evaluation of the cumulative sum curve using the fundoplication time revealed that 17 cases were needed to achieve proficiency and 19 cases to achieve mastery. These results were confirmed with sequential time-block analysis.</div></div><div><h3>Conclusions</h3><div>We report data on the LC for POEM-F. Approximately 17 procedures may be the threshold to achieve proficiency, and approximately 19 cases to master the technique, although larger studies with more endoscopists, both experts and novices, are required.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 332-337"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.04.001
Frederick H. Koh PhD , James W. Li MD , Sunny H. Wong DPhil , Jonathan Lee MD , Sneha John FRACP , Vui Heng Chong MD , Kai-chun Wu MD , Rashid Lui FRCP , Simon S.M. Ng MD , Thomas Y.T. Lam PhD , Louis H.S. Lau MBChB , Govind K. Makharia MD , Murdani Abdullah MD , Hasan Maulahela MD , Nozomu Kobayashi MD , Masau Sekiguchi MD , Jeong-Sik Byeon MD , Hyun-soo Kim MD , Yeong Yeh Lee MD , Han-Mo Chiu MD , Joseph J.Y. Sung MD
Background and Aims
Artificial intelligence (AI)-assisted colonoscopy has been widely investigated for colorectal adenoma and cancer detection and characterization. However, clinical guidance on its use in colorectal cancer (CRC) screening and surveillance is lacking. In this study, we developed consensus guiding when and how to use AI-assisted colonoscopy in the daily practice of screening and surveillance of colorectal neoplasia.
Methods
Experts from 12 Asian-Pacific countries and regions together with 4 international experts developed a set of consensus statements based on existing clinical evidence using the modified Delphi process.
Results
Based on existing evidence, computer-assisted detection should be evaluated for use if available and deemed cost-effective as an adjunct to conventional colonoscopy for CRC screening. Computer-assisted diagnosis may be used for characterization of polyps but is not yet considered sufficient to determine if a polyp is neoplastic and needs to be removed. Computer-assisted quality assurance is generally welcome to improve the quality of colonoscopy. Early engagement of patients and nurses and training of endoscopists to use AI-assisted colonoscopy are crucial for the successful implementation.
Conclusions
More validation studies on AI-assisted colonoscopy need to be done while AI technologies continue to improve.
{"title":"Asia-Pacific consensus on the use of artificial intelligence in colorectal cancer screening and surveillance","authors":"Frederick H. Koh PhD , James W. Li MD , Sunny H. Wong DPhil , Jonathan Lee MD , Sneha John FRACP , Vui Heng Chong MD , Kai-chun Wu MD , Rashid Lui FRCP , Simon S.M. Ng MD , Thomas Y.T. Lam PhD , Louis H.S. Lau MBChB , Govind K. Makharia MD , Murdani Abdullah MD , Hasan Maulahela MD , Nozomu Kobayashi MD , Masau Sekiguchi MD , Jeong-Sik Byeon MD , Hyun-soo Kim MD , Yeong Yeh Lee MD , Han-Mo Chiu MD , Joseph J.Y. Sung MD","doi":"10.1016/j.igie.2025.04.001","DOIUrl":"10.1016/j.igie.2025.04.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Artificial intelligence (AI)-assisted colonoscopy has been widely investigated for colorectal adenoma and cancer detection and characterization. However, clinical guidance on its use in colorectal cancer (CRC) screening and surveillance is lacking. In this study, we developed consensus guiding when and how to use AI-assisted colonoscopy in the daily practice of screening and surveillance of colorectal neoplasia.</div></div><div><h3>Methods</h3><div>Experts from 12 Asian-Pacific countries and regions together with 4 international experts developed a set of consensus statements based on existing clinical evidence using the modified Delphi process.</div></div><div><h3>Results</h3><div>Based on existing evidence, computer-assisted detection should be evaluated for use if available and deemed cost-effective as an adjunct to conventional colonoscopy for CRC screening. Computer-assisted diagnosis may be used for characterization of polyps but is not yet considered sufficient to determine if a polyp is neoplastic and needs to be removed. Computer-assisted quality assurance is generally welcome to improve the quality of colonoscopy. Early engagement of patients and nurses and training of endoscopists to use AI-assisted colonoscopy are crucial for the successful implementation.</div></div><div><h3>Conclusions</h3><div>More validation studies on AI-assisted colonoscopy need to be done while AI technologies continue to improve.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 390-399"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.igie.2025.08.001
Alexandria Lenyo MD , Kyle S. Liu MD , Kasey Hornbuckle MD , Dayna S. Early MD , Jean Wang MD, PhD , Cassandra D.L. Fritz MD, MPHS
Background and Aims
Open-access (OA) colonoscopy expands colorectal cancer (CRC) screening services. Although CRC screening disparities have been established, disparities in the completion of follow-up care after an OA colonoscopy are unknown.
Methods
A retrospective cohort study included patients who had an OA colonoscopy in 2019 at a large nonprofit academic hospital in St Louis, Missouri, United States. Sociodemographic and clinical data were collected for patients who were given a short follow-up interval (<3 years) after the initial OA colonoscopy. The primary outcome was the odds of receiving follow-up care on the basis of sociodemographic factors. Multivariable logistic regressions were used to estimate adjusted odds ratios and 95% confidence intervals (CIs).
Results
Of 2627 patients, 542 (20.6%) received a short-interval follow-up recommendation (mean age 59.8 [standard deviation 8.6 years]; 46.5% female). Most (57.0%) patients identified as a racial minority, with 93.9% (290 of 309) identifying as Black. Only 45.6% (247 of 542) of patients received their recommended short-interval follow-up care. White patients were more likely to receive follow-up care than patients identifying as a racial minority (52.8% vs 40.1%; P = .007). After adjustment for confounders, Black patients were 39% less likely to receive the appropriate follow-up for any recommendation that was <3 years (odds ratio, 0.61; 95% CI, 0.41-0.90).
Conclusions
Minority patients undergoing OA colonoscopy were less likely to receive the recommended short-interval (<3 years) follow-up. Our study suggests that implementing follow-up strategies after OA colonoscopy may be imperative to address disparities in CRC screening and surveillance.
背景和目的开放式结肠镜检查扩大了结直肠癌（CRC）筛查服务。虽然CRC筛查的差异已经确定，但OA结肠镜检查后随访护理完成的差异尚不清楚。方法回顾性队列研究纳入2019年在美国密苏里州圣路易斯市一家大型非营利性学术医院接受OA结肠镜检查的患者。对首次OA结肠镜检查后给予短随访间隔（3年）的患者收集社会人口学和临床资料。主要结果是在社会人口因素的基础上接受随访护理的几率。采用多变量logistic回归来估计调整后的优势比和95%置信区间（ci）。结果在2627例患者中，542例（20.6%）接受了短间隔随访建议（平均年龄59.8岁[标准差8.6岁]，女性46.5%）。大多数（57.0%）患者被认为是少数种族，其中93.9%（309人中有290人）被认为是黑人。542例患者中只有45.6%（247例）接受了推荐的短间隔随访护理。白人患者比少数种族患者更有可能接受随访护理（52.8% vs 40.1%; P = .007）。调整混杂因素后，黑人患者接受3年推荐随访的可能性低39%（优势比0.61;95% CI, 0.41-0.90）。结论：少数接受OA结肠镜检查的患者接受推荐的短间隔随访（3年）的可能性较小。我们的研究表明，OA结肠镜检查后实施随访策略可能是解决CRC筛查和监测差异的必要措施。
{"title":"Characterizing racial disparities in follow-up care after open-access colonoscopy","authors":"Alexandria Lenyo MD , Kyle S. Liu MD , Kasey Hornbuckle MD , Dayna S. Early MD , Jean Wang MD, PhD , Cassandra D.L. Fritz MD, MPHS","doi":"10.1016/j.igie.2025.08.001","DOIUrl":"10.1016/j.igie.2025.08.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Open-access (OA) colonoscopy expands colorectal cancer (CRC) screening services. Although CRC screening disparities have been established, disparities in the completion of follow-up care after an OA colonoscopy are unknown.</div></div><div><h3>Methods</h3><div>A retrospective cohort study included patients who had an OA colonoscopy in 2019 at a large nonprofit academic hospital in St Louis, Missouri, United States. Sociodemographic and clinical data were collected for patients who were given a short follow-up interval (<3 years) after the initial OA colonoscopy. The primary outcome was the odds of receiving follow-up care on the basis of sociodemographic factors. Multivariable logistic regressions were used to estimate adjusted odds ratios and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Of 2627 patients, 542 (20.6%) received a short-interval follow-up recommendation (mean age 59.8 [standard deviation 8.6 years]; 46.5% female). Most (57.0%) patients identified as a racial minority, with 93.9% (290 of 309) identifying as Black. Only 45.6% (247 of 542) of patients received their recommended short-interval follow-up care. White patients were more likely to receive follow-up care than patients identifying as a racial minority (52.8% vs 40.1%; <em>P</em> = .007). After adjustment for confounders, Black patients were 39% less likely to receive the appropriate follow-up for any recommendation that was <3 years (odds ratio, 0.61; 95% CI, 0.41-0.90).</div></div><div><h3>Conclusions</h3><div>Minority patients undergoing OA colonoscopy were less likely to receive the recommended short-interval (<3 years) follow-up. Our study suggests that implementing follow-up strategies after OA colonoscopy may be imperative to address disparities in CRC screening and surveillance.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 325-331"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, the field of endoscopic artificial intelligence has seen significant advancements, largely because of the widespread implementation of deep learning techniques. However, the computer-aided detection (CADe) of the stomach poses significant challenges in clinical practice. Here, we evaluated the performance of a newly developed CADe system, CAD EYE (Fujifilm, Tokyo, Japan), by comparing the frequency of the detection box appearance with white-light imaging (WLI) versus linked-color imaging (LCI) during the process of detecting gastric cancer (GC) and detection of GC with and without CADe.
Methods
This single-center observational retrospective study included 105 patients who underwent esophagogastroduodenoscopy (EGD) using CADe and 105 controls selected by propensity-score matching from 600 patients. The primary outcome was to compare the detection box appearance of WLI and LCI during the CADe observation. Secondary outcomes included comparisons of biopsy rates, examination times, and cancer detection rates between groups. Furthermore, we investigated whether the landmark checker could accurately identify the stomach site.
Results
CADe exhibited an average of 6.2 false-positive detections per case. False-positive rates were significantly lower with LCI than with WLI (3.48 vs 7.70, P < .001). The GC detection rate was higher in the CADe group than in the control group (4.8% vs 1.8%, P = .07), although the difference was not statistically significant. Biopsy rates and examination times were comparable between the groups. CADe accurately detected all 18 known-early GC cases. The landmark checker function identified an average of 5.72 of 7 key gastric sites (81.7%).
Conclusions
This pilot study suggests that CADe, particularly when combined with LCI, may enhance GC detection during EGD without significantly increasing the examination time. Although promising, a high false-positive rate indicates that further optimization is needed.
近年来，内窥镜人工智能领域取得了重大进展，这主要是因为深度学习技术的广泛应用。然而，胃的计算机辅助检测（CADe）在临床实践中提出了重大挑战。在这里，我们通过比较白光成像（WLI）和联色成像（LCI）在检测胃癌（GC）过程中检测盒出现的频率，以及有无CADe的胃癌检测，来评估新开发的CADe系统CAD EYE （Fujifilm, Tokyo, Japan）的性能。方法本研究为单中心观察性回顾性研究，纳入了105例使用CADe进行食管胃十二指肠镜检查（EGD）的患者和从600例患者中通过倾向评分匹配选择的105例对照组。主要结果是比较CADe观察期间WLI和LCI的检测盒外观。次要结果包括组间活检率、检查次数和癌症检出率的比较。此外，我们还研究了标记检查器是否能准确识别胃部位。结果scade平均每例检出6.2例假阳性。LCI组的假阳性率明显低于WLI组（3.48 vs 7.70, P < 0.001）。CADe组GC检出率高于对照组（4.8% vs 1.8%, P = 0.07），但差异无统计学意义。两组间的活检率和检查时间具有可比性。CADe准确地检测出所有18例已知的早期GC病例。landmark checker功能在7个胃关键部位中平均识别出5.72个（81.7%）。结论本初步研究表明，CADe，特别是与LCI联合使用时，可以在不显著增加检查时间的情况下增强EGD期间的GC检测。虽然很有希望，但高假阳性率表明需要进一步优化。
{"title":"Evaluation of computer-aided detection for gastric cancer using white-light and linked-color imaging: a pilot study","authors":"Takeshi Yasuda MD, PhD, Narutoshi Ando MD, Tamae Hashimoto MD, Yoshiaki Kanai MD, Yoichi Sakamoto MD, Yuki Endo MD, PhD, Tomohiro Soda MD, PhD, Takako Akazawa MD, PhD, Tsuguhiro Matsumoto MD, PhD, Norihito Yamauchi MD, Akira Muramatsu MD, PhD, Hiromu Kutsumi MD, PhD","doi":"10.1016/j.igie.2025.09.010","DOIUrl":"10.1016/j.igie.2025.09.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>In recent years, the field of endoscopic artificial intelligence has seen significant advancements, largely because of the widespread implementation of deep learning techniques. However, the computer-aided detection (CADe) of the stomach poses significant challenges in clinical practice. Here, we evaluated the performance of a newly developed CADe system, CAD EYE (Fujifilm, Tokyo, Japan), by comparing the frequency of the detection box appearance with white-light imaging (WLI) versus linked-color imaging (LCI) during the process of detecting gastric cancer (GC) and detection of GC with and without CADe.</div></div><div><h3>Methods</h3><div>This single-center observational retrospective study included 105 patients who underwent esophagogastroduodenoscopy (EGD) using CADe and 105 controls selected by propensity-score matching from 600 patients. The primary outcome was to compare the detection box appearance of WLI and LCI during the CADe observation. Secondary outcomes included comparisons of biopsy rates, examination times, and cancer detection rates between groups. Furthermore, we investigated whether the landmark checker could accurately identify the stomach site.</div></div><div><h3>Results</h3><div>CADe exhibited an average of 6.2 false-positive detections per case. False-positive rates were significantly lower with LCI than with WLI (3.48 vs 7.70, <em>P</em> < .001). The GC detection rate was higher in the CADe group than in the control group (4.8% vs 1.8%, <em>P</em> = .07), although the difference was not statistically significant. Biopsy rates and examination times were comparable between the groups. CADe accurately detected all 18 known-early GC cases. The landmark checker function identified an average of 5.72 of 7 key gastric sites (81.7%).</div></div><div><h3>Conclusions</h3><div>This pilot study suggests that CADe, particularly when combined with LCI, may enhance GC detection during EGD without significantly increasing the examination time. Although promising, a high false-positive rate indicates that further optimization is needed.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 4","pages":"Pages 307-317"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145772039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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