Most Read Articles
Dr Margaret Shi, 18 May 2020

A blood test is shown to be feasible and safe for early detection of multiple cancers in women with no current or known history of cancer, enabling early treatment with curative intent in a subset of individuals.

Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.

Computer-aided system improves lesion detection rate during colonoscopy

Audrey Abella
17 Mar 2020

ENDOANGEL, a quality improvement system for colonoscopy, significantly enhanced colorectal adenoma yield during the procedure, a single-centre study has shown.

“Improvement of the adenoma detection rate (ADR) with [ENDOANGEL] could lead to a reduction in mortality from colorectal cancer (CRC). Moreover, [it could] standardize the technical skills of endoscopists. Our study confirmed the feasibility of using deep learning to improve the quality control of colonoscopy,” said the researchers.

A total of 704 consecutive patients were randomized 1:1 to undergo colonoscopy either unassisted or with the assistance of the ENDOANGEL system. [Lancet Gastroenterol Hepatol 2020;doi:10.1016/S2468-1253(19)30413-3]

In the intention-to-treat (ITT) population, ENDOANGEL significantly outdid the unassisted method in terms of ADR (16 percent vs 8 percent; odds ratio [OR], 2.30; p=0.001). ENDOANGEL also fared significantly better in terms of polyp detection rate (47 percent vs 34 percent; OR, 1.69; p=0.0016) and mean withdrawal time (6.38 vs 4.76 min; p<0.0001).

Longer withdrawal time reportedly leads to higher ADR, hence its importance as an indicator in colonoscopy guidelines, noted the researchers. [Endoscopy 2017;49:378-397; Am J Gastroenterol 2006;101:866-872; N Engl J Med 2006;355:2533-2541]

Endoscope insertion and withdrawal time are typically recorded with a stopwatch by an assistant or endoscopy nurse. [Gastroenterology 2015;149:952-957] Conversely, ENDOANGEL automatically times the withdrawal process, noted the researchers. “[T]herefore, [ENDOANGEL] can give endoscopists real-time feedback to monitor and control the time spent on each colonoscopy.” Moreover, the recorded times may serve as a tool for retrospective observation, they added.

ENDOANGEL also detected more diminutive (≤5 mm) lesions vs the unassisted method in the ITT analysis (13 percent vs 7 percent; OR, 1.91; p=0.015 [adenomas] and 45 percent vs 33 percent; OR, 1.62; p=0.0039 [polyps]). These findings appear to correlate with evidence showing the potential of a computer-aided tool in detecting diminutive, nonneoplastic rectosigmoid polyps. [Ann Intern Med 2018;169:357-366]

The per-protocol analysis revealed similar results favouring ENDOANGEL over the unassisted method in terms of ADR (17 percent vs 8 percent; OR, 2.18; p=0.0026) as well as the other parameters in the ITT analyses. The consistency between the two analyses underline the ability and reliability of ENDOANGEL in this setting, noted the researchers.

 

Potential colonoscopy assistant

Evidence has shown that 26 percent of adenomas are missed during colonoscopy, while 12 percent of CRC cases are not diagnosed during colonoscopies done within 5 years. [Gastroenterology 2019;156:1661-1674; Gastrointest Endosc 2016;84:287-295] Moreover, the varying techniques used may lead to impaired detection of CRC and precursor lesions, noted the researchers.

ENDOANGEL … uses computer vision, real-time monitoring of withdrawal speed, timing of colonoscopy intubation and withdrawal, and provides reminders to endoscopists of blind spots [caused by endoscope slipping], in addition to live-tracking previously seen frames during colonoscopy,” said the researchers. “[Therefore, this] could be a powerful assistant for mitigating skill variations among endoscopists [from subjective factors and external pressure] and improving the quality of everyday colonoscopy.”

Despite its ability to detect diminutive lesions, ENDOANGEL did not fare as well in detecting small lesions (6–9 mm) potentially due to the small sample, noted the researchers. Therefore, larger studies are warranted to substantiate the performance of ENDOANGEL in detecting lesions of different sizes.

The researchers also called for multicentre trials to ascertain the adaptability and efficacy of ENDOANGEL in other centres and regions, they added.

 

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Most Read Articles
Dr Margaret Shi, 18 May 2020

A blood test is shown to be feasible and safe for early detection of multiple cancers in women with no current or known history of cancer, enabling early treatment with curative intent in a subset of individuals.

Christina Lau, 20 Apr 2020

Hippocampal avoidance during whole-brain radiotherapy (HA-WBRT), together with memantine, better preserves cognitive function vs WBRT plus memantine in patients with brain metastases, without compromising survival, a multi-institutional phase III trial has shown.

Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.