Intestinal Research最新文献

{"title":"Recent updates on the endoscopic treatment of rectal neuroendocrine tumor.","authors":"Sunghyeok Ryou, Kwangwoo Nam","doi":"10.5217/ir.2025.00141","DOIUrl":"10.5217/ir.2025.00141","url":null,"abstract":"<p><p>The incidence of rectal neuroendocrine tumors has been gradually increasing, primarily due to the widespread use of screening colonoscopy and growing awareness of the disease. Most rectal neuroendocrine tumors are small ( < 10 mm), well-differentiated, and low-grade lesions at the time of diagnosis, and they are usually asymptomatic. Given these characteristics, endoscopic resection is considered a feasible treatment option for early-stage lesions. However, due to their inherent malignant potential, a comprehensive initial diagnostic evaluation is essential. Lymph node or distal metastasis can be present at diagnosis or may develop long after apparently successful primary treatment. Therefore, achieving complete resection using the most optimal resection method is crucial. Modified endoscopic mucosal resection and endoscopic submucosal dissection are recommended over conventional forceps or snare polypectomy, which are associated with high incomplete resection rates. In case of incomplete resection, additional endoscopic resection can be a feasible option in selected cases. Furthermore, regular post-resection surveillance is needed, especially in patients with high-risk of recurrence such as poor pathologic result or incomplete resection.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"208-213"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-marketing surveillance of tofacitinib in patients with ulcerative colitis in Japan: a post hoc analysis of safety and effectiveness in older (≥65 years) and younger (<65 years) patients.","authors":"Katsuyoshi Matsuoka, Takayuki Yamamoto, Minoru Matsuura, Toshimitsu Fujii, Shoko Arai, Yutaka Endo, Keiko Sato, Hirotoshi Yuasa, Yasushi Mizuno, Yuki Kobayashi, Tadakazu Hisamatsu","doi":"10.5217/ir.2025.00058","DOIUrl":"10.5217/ir.2025.00058","url":null,"abstract":"<p><strong>Background/aims: </strong>To assess, post hoc, tofacitinib safety/effectiveness in patients with ulcerative colitis (UC), stratified by age, using data from a 60-week post-marketing surveillance (PMS) study in Japan.</p><p><strong>Methods: </strong>All patients with UC receiving tofacitinib in Japan were enrolled in a large PMS study. Incidence proportions of adverse events (AEs), incidence rates (IRs; unique patients with events/100 patient-years of exposure) of clinically important AEs, reasons for discontinuation, and partial Mayo score clinical remission, stratified by age ( ≥ 65 and < 65 years), were evaluated.</p><p><strong>Results: </strong>The analysis included 212 older ( ≥ 65 years) and 1,770 younger ( < 65 years) patients. Demographics and baseline disease characteristics were generally similar between groups; however, more older versus younger patients had cardiovascular disease (23.1% vs. 4.6%). Incidence proportions of AEs were comparable between groups, but IRs (95% confidence intervals) in older versus younger patients were numerically higher for herpes zoster (9.81 [5.72-15.71] vs. 5.44 [4.28-6.82]), and higher for serious infections (4.45 [1.92-8.76] vs. 1.14 [0.65-1.85]). More older versus younger patients discontinued due to AEs (28.6% vs. 17.6%); more younger versus older patients discontinued due to insufficient clinical responses (50.3% vs. 35.2%). Clinical remission rates through 60 weeks were generally similar between groups.</p><p><strong>Conclusions: </strong>Older patients had higher IRs of herpes zoster and serious infection than younger patients, although tofacitinib effectiveness was similar between age groups. Discontinuation due to AEs was more common in older patients. Despite the smaller sample size of older versus younger patients, a focused evaluation of older patients is of benefit.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"214-224"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle restrictions are associated with impaired quality of life but not reduction in relapse in ulcerative colitis.","authors":"Hajime Yamazaki, Masakazu Nagahori, Tadakazu Hisamatsu, Taku Kobayashi, Teppei Omori, Jimmy K Limdi, John T McLaughlin, Shu-Chen Wei, Jovelle Fernandez, Shunichi Fukuhara, Katsuyoshi Matsuoka","doi":"10.5217/ir.2024.00199","DOIUrl":"10.5217/ir.2024.00199","url":null,"abstract":"<p><strong>Background/aims: </strong>Patients with ulcerative colitis (UC) in remission commonly restrict thir lifestyle to prevent relapse; however, the effectiveness and impact on quality of life (QOL) is unclear. This study investigated whether lifestyle restrictions are associated with relapse reduction and assessed their impact on QOL.</p><p><strong>Methods: </strong>This multicenter, prospective cohort study was conducted in Japan (2018-2021) via the YOURS registry, enrolling patients with UC in clinical remission. Patients were followed for 2 years. A baseline questionnaire evaluated lifestyle restrictions in diet, work/study/housework, and physical exercise. QOL was assessed by Disease Impact Scale every 3 months during the first year of follow-up. Associations of lifestyle restrictions with relapse and QOL were assessed by Cox regression analysis and linear mixed-effects models, respectively.</p><p><strong>Results: </strong>Among 911 patients in clinical remission for > 90 days, 63% had adopted dietary avoidance; 47%, work/study/housework avoidance; and 8%, physical exercise avoidance. Overall, 216 patients relapsed. Lifestyle restrictions were not associated with reduced risk of relapse (multivariableadjusted hazard ratios [95% confidence interval]: dietary avoidance, 1.08 [0.81-1.44]; and work/study/housework avoidance, 1.14 [0.87-1.50]); physical exercise avoidance was associated with increased relapse (multivariable-adjusted hazard ratio, 1.58; 95% confidence interval, 1.02-2.44). All lifestyle restrictions were associated with impaired QOL (P <0.01).</p><p><strong>Conclusions: </strong>Lifestyle restrictions were not associated with relapse reduction in patients with UC; however, they were associated with impaired QOL. Clinicians should engage in evidence-based discussions with patients with UC in remission regarding lifestyle restrictions (UMIN Clinical Trials Registry; UMIN000031995).</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"225-235"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Week 2 remission with vedolizumab as a predictor of long-term remission in patients with ulcerative colitis: a multicenter, retrospective, observational study.","authors":"Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Mary Cavaliere, Kaori Ishiguro, Jovelle L Fernandez, Toshifumi Hibi","doi":"10.5217/ir.2025.00047","DOIUrl":"10.5217/ir.2025.00047","url":null,"abstract":"<p><strong>Background/aims: </strong>Vedolizumab (VDZ), a gut-selective monoclonal antibody for ulcerative colitis (UC) treatment, has no established biomarkers or clinical features that predict long-term remission. Week 2 remission, a potential predictor of long-term remission, could inform maintenance treatment strategy.</p><p><strong>Methods: </strong>This retrospective, observational chart review included patients with UC in Japan who initiated VDZ between December 2018 and February 2020. Outcome measures included 14- and 54-week remission rates in patients with week 2 and non-week 2 remission (remission by week 14), 54-week remission rates in patients with week 14 remission and primary nonresponse, and predictive factors of week 2 and week 54 remission (logistic regression).</p><p><strong>Results: </strong>Overall, 332 patients with UC (176 biologic-naïve and 156 biologic-non-naïve) were included. Significantly more biologic-naïve than biologic-non-naïve patients achieved week 2 remission (36.9% vs. 28.2%; odds ratio [OR], 1.43; 95% confidence interval [CI], 1.05-1.94; P= 0.0224). Week 54 remission rates were significantly different between week 14 remission and primary nonresponse (both groups: P< 0.0001), and between week 2 and non-week 2 remission (all patients: OR, 2.41; 95% CI, 1.30-4.48; P= 0.0052; biologic-naïve patients: OR, 2.40; 95% CI, 1.10-5.24; P= 0.0280). Week 2 remission predictors were male sex, no anti-tumor necrosis factor alpha exposure, and normal/mild endoscopic findings. Week 54 remission was significantly associated with week 2 remission and no tacrolimus use.</p><p><strong>Conclusions: </strong>Week 2 remission with VDZ is a predictor of week 54 remission in patients with UC. Week 2 may be used as an evaluation point for UC treatment decisions. (Japanese Registry of Clinical Trials: jRCT-1080225363).</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"293-305"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antinuclear antibodies seroconversion and endoscopic response to infliximab in biologic-naive Crohn's disease: a Chinese single-center, retrospective study.","authors":"Jinlu Tong, Xitao Xu, Yuan Cao, Mingming Zhu, Juntao Lu, Yuqi Qiao, Zhanghan Dai, Tianrong Wang, Ying Sun, Zhijun Cao, Shen Jun","doi":"10.5217/ir.2025.00018","DOIUrl":"10.5217/ir.2025.00018","url":null,"abstract":"<p><strong>Background/aims: </strong>The development of antinuclear antibodies (ANAs) during infliximab treatment has been observed in previous clinical trials. To evaluate the clinical significance of ANA seroconversion and its potential association with the formation of antibodies against infliximab.</p><p><strong>Methods: </strong>This retrospective study included 130 Crohn's disease patients undergoing infliximab therapy. ANA titers were measured at baseline and after 6 months of treatment. Inverse probability of treatment weighting was applied to control for confounding variables.</p><p><strong>Results: </strong>Among the 111 patients with negative baseline ANA, 36 (32.4%) developed ANA positivity after 6 months of infliximab treatment. After adjustment with inverse probability of treatment weighting, a significantly higher proportion of patients in the ANA non-seroconversion group achieved endoscopic remission at 6 months compared to those with ANA seroconversion (64.5% vs. 35.5%: adjusted odds ratio [aOR], 3.61; 95% confidence interval [CI], 1.30-10.02; P= 0.014). At 18 months, patients in the non-seroconversion group also exhibited higher rates of both endoscopic response (57.5% vs. 42.3%: aOR, 3.38; 95% CI, 1.15-9.96; P= 0.027) and endoscopic remission (60.0% vs. 40.1%: aOR, 2.91; 95% CI, 1.06-8.01; P= 0.039) compared to the seroconversion group. Additionally, patients who developed ANA seroconversion had a higher rate of detectable antibodies against infliximab at both 6 and 18 months. A multivariable analysis identified female sex, older age at diagnosis, and lower serum albumin levels as independent predictors of ANA seroconversion at 6 months.</p><p><strong>Conclusions: </strong>ANA non-seroconversion at 6 months was associated with higher rates of endoscopic remission and a lower likelihood of developing antibodies against infliximab.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"376-383"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment patterns and outcomes in patients with steroid-dependent ulcerative colitis in Japan: a claims database study.","authors":"Masayuki Saruta, Takumi Sugiyama, Takumi Tajima, Chisa Nagakura, Yan Zhong, Toshihiko Kaise","doi":"10.5217/ir.2025.00032","DOIUrl":"10.5217/ir.2025.00032","url":null,"abstract":"<p><strong>Background/aims: </strong>Guidelines recommend that steroid treatment for ulcerative colitis (UC) is tapered or withdrawn within 3 months of initiation, and thiopurine treatment or advanced therapy is administered for steroid-dependent UC. This study aimed to clarify real-world treatment patterns and outcomes in patients with steroid-dependent UC in Japan.</p><p><strong>Methods: </strong>A retrospective analysis of JMDC (Japan Medical Data Center) claims data was conducted to identify patients with a new UC diagnosis between June 2010 and September 2019. Index dates were the UC treatment start date (initiation of any UC treatment), steroid dependence/resistance confirmation date (identification of steroid-dependent UC), and treatment intensification date (initiation of thiopurine treatment/advanced therapy).</p><p><strong>Results: </strong>Of 5,602 patients with newly diagnosed UC, 986 (17.6%) initiated steroids within 12 months (85.4% [842/986] received 5-aminosalicylic acid at the UC treatment start date). Of these 986 patients, 429 (43.5%) were classified as steroid-dependent (steroid dependence/resistance confirmation date). Of these 429 patients, 128 (29.8%) initiated thiopurine treatment and 75 (17.5%) initiated advanced therapy (treatment intensification date); 226 (52.7%) continued with steroids only. Across these groups, 3-6% discontinued steroids within 3 months of initiation. Hospitalization due to UC in the 12 months after the treatment intensification date occurred in 24.2% (31/128) and 18.7% (14/75) of patients who initiated thiopurine and advanced therapy, respectively.</p><p><strong>Conclusions: </strong>Over half of patients with steroid-dependent UC continued steroid treatment only. Steroid discontinuation within 3 months of initiation was low, irrespective of whether thiopurines or advanced therapy were initiated. Management of patients with steroid-dependent UC in Japan requires further treatment optimization toward guideline adherence.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"366-375"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of carotegrast methyl in active ulcerative colitis: a real-world prospective cohort study.","authors":"Takahiro Shimoyama, Takayuki Yamamoto, Haruka Miyao, Saki Aota, Shoichi Morita, Ryohei Sakaguchi","doi":"10.5217/ir.2025.00046","DOIUrl":"10.5217/ir.2025.00046","url":null,"abstract":"<p><strong>Background/aims: </strong>Carotegrast methyl, an oral α4-integrin inhibitor, was recently approved for the treatment of active ulcerative colitis (UC). However, real-world data regarding its efficacy and safety remain scarce. This study aimed to assess the clinical effectiveness and safety profile of carotegrast methyl in patients with active UC.</p><p><strong>Methods: </strong>Patients with active UC received carotegrast methyl at a dosage of 960 mg three times daily. Treatment was discontinued at 8 weeks for patients who achieved endoscopic remission. For those not achieving endoscopic remission, treatment was continued for up to 24 weeks. Clinical and endoscopic assessments were performed at 8 and 24 weeks to evaluate treatment progress.</p><p><strong>Results: </strong>Among 50 UC patients, 45% achieved clinical remission, and 22% achieved endoscopic remission by week 8. Of those who discontinued treatment after reaching endoscopic remission, 55% experienced relapse during a median follow-up period of 30 weeks. For patients who continued treatment through 24 weeks, 52% achieved clinical remission, with a cumulative remission maintenance rate of 74.2%. Mild adverse events were reported in 6% of patients, including hyperamylasemia, hepatic dysfunction, and elevated biliary enzymes, all of which resolved after discontinuation of treatment. In 8 patients who relapsed and were re-administered carotegrast methyl, 62.5% achieved clinical remission, demonstrating the drug's effectiveness and safety in re-treatment.</p><p><strong>Conclusions: </strong>Carotegrast methyl effectively induces both clinical and endoscopic remission in patients with active UC and has a favorable safety profile. Re-administration is safe and effective for patients experiencing relapse.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":"306-315"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biology and preclinical models of colorectal cancer metastasis.","authors":"Yoojeong Seo, Jinho Jang, Jae-Il Park","doi":"10.5217/ir.2025.00315","DOIUrl":"10.5217/ir.2025.00315","url":null,"abstract":"<p><p>Metastatic colorectal cancer (mCRC) is the principal cause of CRC-related mortality, yet the biology of mCRC remains only partly understood and challenging to interrogate experimentally. Despite recent progress in mapping recurrent genetic and epigenetic alterations and treatment responses of mCRC, these efforts provide limited insight into how heterogeneous primary tumors breach tissue barriers, survive in circulation, and colonize distant organs. In this review, we summarize current experimental systems for studying mCRC, including genetically engineered mouse models, carcinogen-induced and transplant models, and patient-derived organoid and xenograft platforms, and discuss how each captures or fails to capture key steps of the metastatic cascade and organ-specific microenvironments. We highlight practical obstacles to longitudinal sampling and quantitative readouts of metastatic burden, as well as conceptual gaps in modeling immune and stromal influences. Finally, we outline how emerging approaches, including single-cell and spatial transcriptomics, and advances in longitudinal tracking of metastatic burden could be combined into an integrated framework that more faithfully links mechanistic insight to clinical behavior and ultimately to metastasis-specific therapies.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512134","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}

{"title":"Clinical usefulness of fecal calprotectin in assessing disease activity and endoscopic remission in intestinal Behçet's disease.","authors":"Woojin Ahn, Seoyoon Choi, So Jung Han, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jihye Park, Jae Hee Cheon","doi":"10.5217/ir.2025.00267","DOIUrl":"https://doi.org/10.5217/ir.2025.00267","url":null,"abstract":"<p><strong>Background/aims: </strong>Intestinal Behçet's disease (BD) is a manifestation of BD involving the gastrointestinal tract. Although fecal calprotectin (FC) is a useful inflammatory marker, its role in intestinal BD is unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 78 patients with intestinal BD to evaluate correlations between FC levels and the Disease Activity Index for Intestinal Behçet's Disease (DAIBD), C-reactive protein (CRP), and erythrocyte sedimentation rate. FC and CRP levels were compared between patients in endoscopic remission and those with active disease. Receiver operating characteristic (ROC) curve analysis was used to evaluate FC's ability to predict endoscopic activity and ulcer size.</p><p><strong>Results: </strong>FC levels significantly correlated with DAIBD scores (r= 0.253, P= 0.025) and CRP (r= 0.227, P= 0.046). Patients with endoscopically active disease had higher FC (1,124 ± 1,957 μg/g vs. 367 ± 1,208 μg/g; P< 0.001) and CRP levels (16.0 ± 23.7 mg/L vs. 14.4 ± 46.5 mg/L; P= 0.027) than those in remission. Patients with larger ulcers ( ≥ 30 mm) had higher FC levels than those with smaller ulcers (2,212 ± 2,609 μg/g vs. 962 ± 1,822 μg/g; P= 0.034). An FC cutoff level of 176 μg/g discriminated active endoscopic disease (sensitivity 59.3%, specificity 83.3%), with an area under the ROC curve (AUC) of 0.724 (95% confidence interval, 0.605-0.843; P= 0.002), outperforming CRP (AUC, 0.657).</p><p><strong>Conclusions: </strong>FC levels correlated with DAIBD scores and endoscopic inflammation in intestinal BD. FC outperformed CRP in detecting endoscopic activity, supporting its use in disease management.</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512129","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}

{"title":"Prospective evaluation of artificial intelligence-assisted monitoring of the effective withdrawal time on adenoma detection.","authors":"Thomas Ka Luen Lui, Carla Pui-Mei Lam, Vivien Wai-Man Tsui, Rex Wan-Hin Hui, Elvis Wai-Pan To, Loey Lung-Yi Mak, Michael Kwan-Lung Ko, Kevin Sze-Hang Liu, Cynthia Ka-Yin Hui, Jing Jia Liu, Xiao Xiao, Wai K Leung","doi":"10.5217/ir.2025.00262","DOIUrl":"https://doi.org/10.5217/ir.2025.00262","url":null,"abstract":"<p><strong>Background/aims: </strong>Standard withdrawal time (SWT) is a recognized colonoscopy quality metric but may not capture mucosal examination quality. We developed an artificial intelligence (AI)-derived metric, effective withdrawal time (EWT), to quantify clear mucosal visualization. This study prospectively evaluated EWT versus SWT on adenoma detection rate (ADR) and other metrics.</p><p><strong>Methods: </strong>In this prospective single-center study, patients undergoing colonoscopy were enrolled. EWT was calculated in real-time using an AI system with endoscopists blinded to results. Multivariable analyses assessed the association of EWT and SWT with binary (e.g., ADR) and count outcomes (e.g., adenoma or polyp per colonoscopy [APC or PPC]), adjusting for patient and procedural characteristics.</p><p><strong>Results: </strong>We analyzed 193 colonoscopies by 16 endoscopists. After adjustment, each 1-minute EWT increase was associated with higher odds of adenoma detection (ADR: odds ratio [OR], 1.38; 95% confidence interval [CI], 1.15-1.67) and a > 2-fold increase in adenomas detected per procedure (APC: incidence rate ratio [IRR], 2.14; 95% CI, 1.97-2.32). Both parameters were significantly better with EWT than SWT (OR, 1.38 vs. 1.06; P< 0.01 for ADR; IRR, 2.14 vs. 1.15; P= 0.02 for APC). EWT demonstrated stronger correlation with APC (R2 = 0.97) and PPC (R2 = 0.96) than SWT (R2 = 0.67 and 0.68, respectively; P< 0.01).</p><p><strong>Conclusions: </strong>AI-derived EWT is a novel quality indicator reflecting mucosal examination thoroughness, serving as a stronger, more independent predictor of ADR than SWT. (Clinical Trials.gov identifier: NCT06063720).</p>","PeriodicalId":14481,"journal":{"name":"Intestinal Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473836","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}