Artificial intelligence improves adenoma detection rate during colonoscopy.

BACKGROUND: Artificial intelligence-assisted colonoscopy (AIAC) has gained attention as a tool to assist with polyp detection during colonoscopy. Uncertainty remains as to the clinical benefit, given limited publications using different modules. METHOD: A single-centre retrospective study was performed at Waitemata Endoscopy, a private endoscopy centre in Auckland, New Zealand. An Olympus Endo-AID module was utilised for the first time by 13 experienced endoscopists. Outcomes from AIAC between 10 March 2021 to 23 April 2021 were compared to a subsequent non-AI conventional colonoscopy (CC) control group from 27/4/21 to 20/6/21. RESULTS: A total of 213 AIACs were compared with 213 CCs. Baseline patient age, gender, indication for procedure, bowel preparation scores and specialty of proceduralist (gastroenterologist or surgeon) were well matched (p>0.05). The withdrawal time was significantly longer in the AIAC group compared to CC controls (15 vs 13 minutes; p<0.001). The adenoma detection rate (ADR) was significantly higher in the AIAC group compared to CC group (47.9% vs 38.5%; odds ratio 1.59; 95% CI [1.05-2.41]; p=0.03). The overall polyp detection rate (PDR) was similar between groups (70% vs 70%; p=0.79). Analysis by polyp size, location and other histology was not significant between groups. CONCLUSION: AI-assisted colonoscopy significantly improved ADR compared with conventional colonoscopy. Further research is required to understand its utility and impact on long-term clinical outcomes.

Primary pleural epithelioid hemangioendothelioma mimicking as a posterior mediastinal tumor.

A 41-year-old man with no previous asbestos exposure presented with 6 months of dull right lower chest pain and weight loss. The initial computed tomography (CT) scan was reported as showing a soft tissue thickening in the posterior mediastinum with non-specific nodules in the horizontal and oblique fissures. An endoscopic ultrasound-guided fine needle aspiration from the 12 × 25 mm heterogeneous posterior mediastinal mass was suspicious for a ganglioneuroma. The procedure was complicated by a large hemothorax requiring drainage. A subsequent positron emission tomographic CT revealed a moderately fluorodeoxyglucose avid area of pleural thickening extending from the sixth to ninth thoracic vertebral body in the paraspinal region along with nodules along the right horizontal and oblique fissures. A thoracoscopic biopsy of the pleural lesion confirmed a pleural epithelioid hemangioendothelioma. There was a 5-mm reduction in tumor thickness and improvement in his pain following 54 Gy of radiotherapy.

Zolendronate associated inflammatory orbital disease.

Bisphosphonate infusions are associated with adverse events in approximately a third of patients. Ocular complications are rare and even more so, inflammatory orbital disease. Bisphosphonate-induced orbital inflammation is not a well recognised complication and there have been only a few published case reports of this. We present a case of orbital inflammatory disease associated with zolendronate infusion.