Chief of Gastroenterology at the Hackensack University Medical Center, Dr. Rosario Ligresti, MD talks about a new way to perform colonoscopies.
Interview conducted by Ivanhoe Broadcast News in 2022.
Most of our viewers will be familiar with colonoscopy, has that been the gold standard to this point, standard colonoscopy for finding and diagnosing colon cancer?
LIGRESTI: The gold standard for colon cancer screening has always been colonoscopy. We have compared all new technologies to colonoscopy and we know that colonoscopy is extremely effective to find early polyps which become colon cancer and remove them successfully. Now, as time has gone on, we’ve discovered that colonoscopy is probably not as accurate as it ultimately should be and that’s why new technologies have started to take root.
Could you tell me a bit about the GI Genius? You’re talking about new technology. In what ways is the GI Genius something that viewers will be familiar with, and in what ways is it completely new?
LIGRESTI: Little by little, society is getting more and more used to computers in our lives. As we now have self-driving cars, we have other elements of artificial intelligence in our lives. So, what does artificial intelligence bring to medicine? It brings increased level of accuracy; it brings an ability of an unblinking observer to watch what we’re doing as physicians. Colonoscopy by its very nature, sometimes as you do the procedure, you don’t see everything that you need to see. What the computer allows us to do, what GI Genius allows us to do is provide an extra set of eyes always watching the screen, and a couple of set of eyes that don’t get tired, that don’t get fatigued, that know what they’re looking for, and it’s on working 24 hours a day.
Can you walk our viewers through how this would work?
LIGRESTI: The patients undergo what they would consider to be a standard colonoscopy. They get sedatives, they fall asleep, they have a colonoscope inserted into the colon, and advance through the colon from one end to the other. Then as the camera is withdrawn, through the colon, GI Genius is doing its thing. It’s a box that interprets every image, every frame of the colonoscopy in real-time and alerts the physician in real-time on the screen by a little green box and a little buzzer where it thinks there’s a problem. If in fact, the GI Genius identifies a polyp. At the end of the day, it’s still up to the physician what to do with that polyp but clearly, those polyps up the GI Genius module are telling you to remove them, those polyps should be removed. When we discovered that this is very accurate and this is far more attentive than physicians can be during colonoscopy, it became an extra assistant for you during a colonoscopy to help make colonoscopy examinations that much better.
When the tube is going through the colon, is it a camera that’s mounted or what is the tool that allows doctors to see in real-time and allows the computer to alert doctors in real-time?
LIGRESTI: Yes. Going back to what colonoscopy is, is basically a very long, very flexible, and small thin device that at the very end of it is attached to a small camera and some air and water tubing to allow the physicians to see in real-time on the screen the inside of the colon. Through this instrument allows us to remove all biopsy tissue as we see it. The GI Genius module attaches to a standard colonoscopy processor and interprets all the images that are coming through the colonoscope before they get to the screen, it interprets those images in real-time.
What is the benefit to the doctor of having this extra set of eyes?
LIGRESTI: We know that every time that a physician finds a polyp, they decrease the patient’s rate of developing colon cancer. As that polyp was identified and removed, that polyp cannot cause colon cancer clearly because it’s been removed. We know that the more polyps you find during a screening colonoscopy examination, the better the examination is qualitatively. That’s a measurable number. It’s called the adenoma detection rate, how often a physician in an average-risk patient is finding adenoma. An adenoma is a precancerous polyp. We know that the increase in adenoma detection rate, the increase in the ability of the doctor to find more polyps decreases the patient’s risk of getting colon cancer. By adding GI Genius, you’re increasing the adenoma detection rate by 14 percent. Again, now we’re talking real numbers. These numbers suddenly now make a dent in the benefit of colonoscopy if the average colonoscopy can be considered 89 percent accurate, then adding GI Genius makes it into the low 90s. Suddenly you get that exact same examination, a much better study.
Can patients notice or feel a difference?
LIGRESTI: Not at all. What solid data has shown us this year is that it adds about 1-2 minutes to the length of the examination for the colonoscopy. The patients don’t know the difference, at the end of the study though, they’ve gotten a better colonoscopy.
Are there false positives? Are there times when the little green light goes off?
LIGRESTI: Yes. At the end of the day, the physician oversees the study. The machine is there to help you, and it’ll tell you in real-time when it thinks there’s a polyp, the physician based on his clinical expertise will determine if it’s a polyp that’s clinically significant. Oftentimes the machine will interpret a bubble, or some stool, or some debris as a polyp. Thank goodness, the machine is so accurate these days because inside the machine, there are 14 million images that it compares your image to so it’s very accurate. In fact, the false positivity rate is probably two percent. We know that the machine is very accurate and if the machine is telling you, it thinks this is a polyp, more than likely it’s a polyp that should be removed.
Is there anything I didn’t ask you about this that you would want to make sure our viewers know?
LIGRESTI: Cost is probably important.
Does it cost more for a patient to have?
LIGRESTI: Yes. The actual technology doesn’t cost the patient anything else. It’s covered the way of screening colonoscopy would be covered by insurance, it doesn’t cost the patient any additional expense, any additional time, or risk to undergo the procedure.
When was this FDA approved?
LIGRESTI: It was approved by the FDA exactly one year ago.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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