Impact of Artificial Intelligence Use on Endoscopist Optical Diagnosis of Sessile Serrated Lesions, Traditional Serrated Adenomas and Advanced Conventional Adenomas

Objectives: Evaluate CADx-assisted and unassisted endoscopist optical diagnosis of sessile serrated lesions (SSLs), traditional serrated adenomas, and advanced adenomas. Methods: We performed an IRB-approved secondary analysis of a large prospective colonoscopy cohort. Results: Of 2111 polyps (1011 patients), 116 were histopathology-proven SSLs. Sensitivity for SSL identification of CADx-assisted and unassisted optical diagnosis was 55.7% (95%CI 42.9-67.8) and 38.6% (95%CI 22.7-57.3) respectively. Endoscopists correctly identified SSLs more frequently when CADx classified these as hyperplastic compared to neoplastic, (66.7%[95%CI 51.8-78.9] vs 24.5%[95%CI 10.8-46.3]; p<0.001). Conclusions: CADx use did neither significantly harm nor improve optical diagnostic performance for SSLs despite CADx inability to classify SSLs.