---
title: >-
  Three Italian endoscopy centers using GI Genius: Real-time AI computer-aided adenoma
  detection during colonoscopy
slug: gi-genius-colonoscopy-detection
stable_id: fb7af1efc542b6d1
company: Three Italian endoscopy centers using GI Genius
function_code: clinical_ops
pattern_codes:
  - creator_to_judge
evidence_strength: verified
publication_tier: showcase
freshness: current
reviewed_at: '2026-08-23'
updated_at: '2026-08-22'
source_quality_summary: 1 peer reviewed; publication outcomes are verified.
caveat_summary: >-
  Randomized detection endpoint; the trial did not establish reduced colorectal-cancer
  mortality, and much of the uplift was in small lesions.
collections:
  - human-still-decides
  - regulated-autonomy
bundle_version: 1.0.0
bundle_fingerprint: sha256:c23c6cc2b88153d008ea8fda928f632ce0011fc2d4c5036672a16e5d895bab93
canonical_url: https://brianletort.ai/transformations/gi-genius-colonoscopy-detection
---

# Three Italian endoscopy centers using GI Genius: Real-time AI computer-aided adenoma detection during colonoscopy

That the endoscopist must be the only visual observer capable of flagging a lesion during withdrawal.

Function: Clinical operations. Patterns: Creator to judge. Evidence: verified.

Freshness: current. Reviewed: 2026-08-23. Updated: 2026-08-22.


Source quality: 1 peer reviewed; publication outcomes are verified.

## Before

1. **Endoscopist** — Inspect the live colonoscopy feed and visually identify suspected lesions. (control: Clinical judgment and minimum withdrawal time)
2. **Pathologist** — Determine whether removed tissue is neoplastic. (control: Histopathology reference standard)

## After

1. **GI Genius CADe** — Processes the live video and superimposes a green box over a suspected lesion. (control: Real-time computer-aided detection)
2. **Endoscopist** — Inspects the highlighted area and decides whether to remove tissue. (control: Physician retains procedural decision rights)

## Decision rights

The AI draws attention; the endoscopist decides whether a finding is real and whether to resect.

## Exception path

The physician ignores false alerts, inspects missed or ambiguous tissue directly, and relies on histopathology for final classification.

## Outcomes

- **Adenomas detected per colonoscopy** (verified): 0.71 mean adenomas per colonoscopy in the standard-colonoscopy control group → 1.07 in the CADe group; incidence-rate ratio 1.46, with no increase in withdrawal time. Randomized detection endpoint; the trial did not establish reduced colorectal-cancer mortality, and much of the uplift was in small lesions.

## Executive lesson

The model changed the attention workflow rather than the clinical decision right; value came from watching every frame without slowing the procedure.

## Anti-pattern

Calling every AI box a diagnosis or extrapolating detection uplift to mortality.

## Questions for leaders

- Does the AI change attention or authority?
- What is the false-alert burden at operating speed?

## Sources

- [Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial](https://europepmc.org/article/med/32371116) — Gastroenterology / Europe PMC