Performance of computer-aided diagnosis for colorectal sessile serrated lesions: A systematic review and meta-analysis

doi:10.3748/wjg.118009

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jul 21, 2026; 32(27): 118009
Published online Jul 21, 2026. doi: 10.3748/wjg.118009

Table 1 Study characteristics for sessile serrated lesions vs non-sessile serrated lesions, n (%)

Ref.	Design¹	Center	Country	Type of endoscope	Polyp size	Histology criteria of WHO	AI segmentation/classification type	Real time	Images/videos	Imaging type	Image set (n)	Patients (n)	SSL image set (n)	SSL
Ozawa et al[22]	R	Single	Japan	Olympus	NA	2010	Single Shot MultiBox Detector/ODA	N	Images	WLI	783	174	23	7 (2)
Ozawa et al[22]	R	Single	Japan	Olympus	NA	2010	Single Shot MultiBox Detector/ODA	N	Images	NBI	290	174	6	7 (2)
Pu et al[24]	R	Single	Japan	Olympus	NA	2010	DenseNets/ICA	N	Images	NBI	20	NA	2	2 (10)
Pu et al[24]	R	Single	Japan	Fujifilm	NA	2010	DenseNets/ICA	N	Images	BLI	49	NA	10	10 (20)
Kader et al[28]	P	Single	United Kingdom	Olympus	NA	2019	Resnet101/ICA	N	Videos	NBI	157²	199	27²	27 (17)
Kader et al[28]	P	Single	United Kingdom	Olympus	NA	2019	Resnet101/ICA	N	Videos	NBI	65²	31	10²	10 (15)
Houwen et al[27]	P	Multiple	Netherlands	Olympus	≤ 5	2010	YOLO v4/ODA	Y	Videos	NBI	423²	194	7²	7 (2)
Song et al[23]	R	Single	Korea	Olympus	NA	2010	DenseNet-201/ICA	N	Images	NBI	182	182	39	24 (13)
Song et al[23]	P	Single	Korea	Olympus	NA	2010	DenseNet-201/ICA	N	Images	NBI	546	363	117	70 (19)

¹Represents a retrospective or prospective study.

²Represents the use of video data.

AI: Artificial intelligence; WHO: World Health Organization; SSL: Sessile serrated lesion; R: Retrospective; P: Prospective; NA: Not available; ODA: Object detection algorithm; ICA: Image classification algorithm; N: No; Y: Yes; WLI: White light images; NBI: Narrow band imaging; BLI: Blue light imaging.

Full Size Table

Table 2 Meta regression analysis for possible factors affecting the sensitivity of computer-aided diagnosis in distinguishing sessile serrated lesions from non-sessile serrated lesions and hyperplastic polyps

Factors	Sensitivity (SSL vs non-SSLs)				Sensitivity (SSL vs HPs)
	Univariate analysis		Multivariate analysis		Univariate analysis		Multivariate analysis
	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)
Publication time (vs year 2020)	0.67	1.77 (0.13-23.36)			0.48	2.49 (0.20-31.49)
Multicenter (vs single center)	0.10	0.09 (0.01-1.61)			0.06	0.03 (0.00-1.19)	0.14	0.10 (0.00-2.09)
Europe (vs Asia)	0.67	1.77 (0.13-23.36)			0.64	1.97 (0.12-33.01)
Prospective (vs retrospective)	0.67	1.77 (0.13-23.36)			0.33	3.40 (0.29-39.44)
Olympus (vs Fujifilm)	0.83	0.66 (0.02-27.83)			0.11	6.84 (0.65-72.26)
Criteria 2019 (vs 2010)	0.06	11.15 (0.90-138.8)	0.07	2.97 (0.92-9.53)	0.19	4.55 (0.47-43.74)
ICA (vs ODA)	< 0.01	16.22 (7.73-34.05)	< 0.01	14.13 (6.89-29.01)	0.18	5.28 (0.47-59.22)
Real time (vs nonreal time)	0.10	0.09 (0.01-1.61)			0.58	0.41 (0.02-9.53)
Images (vs videos)	0.67	0.57 (0.04-7.47)			0.64	0.51 (0.03-8.48)
NBI (vs non-NBI)	0.47	2.68 (0.18-39.61)			0.01	10.80 (1.97-59.33)	0.02	7.27 (1.40-37.63)

SSL: Sessile serrated lesion; HPs: Hyperplastic polyps; OR: Odds ratio; CI: Confidence interval; ICA: Image classification algorithms; ODA: Object detection algorithm; NBI: Narrow band imaging.

Full Size Table

Citation: Zhang S, Wang SH, Zhao YD, Wei JH, Sui XY, Li X, Zhang HW, Huang ZY, Wang CL, Hu H, Zhang J, Li ZS, Zhao SB, Bai Y. Performance of computer-aided diagnosis for colorectal sessile serrated lesions: A systematic review and meta-analysis. World J Gastroenterol 2026; 32(27): 118009
URL: https://www.wjgnet.com/1007-9327/full/v32/i27/118009.htm
DOI: https://dx.doi.org/10.3748/wjg.118009

Zhang S, Wang SH, Zhao YD, Wei JH, Sui XY, Li X, Zhang HW, Huang ZY, Wang CL, Hu H, Zhang J, Li ZS, Zhao SB, Bai Y. Performance of computer-aided diagnosis for colorectal sessile serrated lesions: A systematic review and meta-analysis. World J Gastroenterol 2026; 32(27): 118009 [DOI: 10.3748/wjg.118009]

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