Advances in artificial intelligence-based colonoscopic tools and modalities: Transforming colorectal cancer detection and management

Table 2 Summary of randomized controlled trials assessing the clinical performance of artificial intelligence-assisted colonoscopy

Ref.	Study design	Participants	AI system/intervention	Main outcomes	Key findings
Repici et al[23], 2020	Multicenter randomized trial	685 patients	GI-genius CADe system	ADR, adenomas per colonoscopy	AI-assisted colonoscopy significantly increased ADR (54.8% vs 40.4%) and adenomas detected per colonoscopy, mainly due to improved detection of small adenomas ≤ 9 mm without increasing withdrawal time
Seager et al[24], 2024	Multicenter randomized control trial (COLO-DETECT trial)	Not specified in text	GI-genius CADe system	ADR, adenomas per procedure	AI significantly improved ADR (56.6% vs 48.4%) and mean adenomas per procedure without increasing adverse events
Nakashima et al[25], 2023	Randomized trial	415 patients	CADe-assisted colonoscopy	ADR, adenoma miss rate	Computer-aided detection improved ADR (59.4% vs 47.6%) and reduced adenoma miss rates in the rectosigmoid colon without prolonging examination time
Wang et al[26], 2020	Double-blind randomized trial	962 patients	CADe system	ADR	ADR significantly improved (34% vs 28%). AI particularly enhanced detection of subtle lesions such as small, flat, or partially hidden polyps
Lau et al[27], 2024	Randomized trial	766 patients	Computer-aided detection -assisted colonoscopy	ADR	CADe significantly increased ADR among endoscopists-in-training and improved detection of small adenomas in both right and left colon
Xu et al[28], 2021	Randomized trial	2352 patients	AI-assisted colonoscopy	Polyps per colonoscopy	AI increased detection of additional polyps per colonoscopy and improved identification of diminutive and flat lesions
Glissen Brown et al[29], 2022	Tandem colonoscopy randomized contral trial	Not specified in text	CADe-system	Adenoma miss rate	CADe significantly reduced adenoma miss rate (20.1% vs 31.3%) and increased adenomas detected per colonoscopy
Luo et al[30], 2021	Randomized back-to-back colonoscopy study	150 patients	Real-time AI polyp detection system	PDR	AI significantly improved polyp detection rate, mainly through improved detection of diminutive polyps

AI: Artificial intelligence; ADR: Adenoma detection rate; PDR: Polyp detection rate; CADe: Computer-aided detection; GI: Gastrointestinal.