S549 Comparative Efficacy of SKOUT and GI Genius: A Pilot Study of Artificial Intelligence-Assisted Polyp Detection During Colonoscopy

Introduction: Colorectal cancer (CRC) is a major cause of mortality. Colonoscopy remains the gold standard for prevention, though adenoma detection rates (ADR) vary due to human error and interobserver differences. Computer-aided detection (CADe) systems using artificial intelligence (AI) aim to improve polyp detection and reduce variability. GI Genius (Medtronic) and SKOUT (Iterative Health) are 2 FDA-approved platforms. GI Genius has demonstrated up to a 30% increase in ADR, while SKOUT improves ADR and sessile serrated lesion detection without prolonging withdrawal time. Comparative studies are limited. The aim of our study was to compare the real-world performance of both systems across multiple endoscopy centers in our healthcare system. Methods: We retrospectively analyzed colonoscopies using SKOUT or GI Genius across 2 endoscopy centers in our healthcare system between June and December 2024. Indications for colonoscopy were classified as either screening, surveillance, or diagnostic. Endoscopic and histopathologic findings were abstracted to assess ADR, polyp detection rate (PDR), adenomas per colonoscopy (APC), adenomas per positive procedure (APP), and true histologic resection (THR). Categorical and continuous variables were compared using the Chi-Squared test or Student’s t-test, respectively. Results: A total of 233 SKOUT-assisted and 143 GI Genius-assisted colonoscopies were included. As shown in Table 1, ADR for SKOUT vs GI Genius was 48.1% and 44.1% (P = 0.52), respectively. PDR for SKOUT vs GI Genius was 56.2%, and 60.8% (P = 0.44), respectively. The APC for SKOUT vs GI Genius was 1.14 and 1.08 (P = 0.62), respectively. The APP for SKOUT vs GI Genius was 2.37 and 2.44 (P = 0.68), respectively. Lastly, the THR for SKOUT vs GI Genius was 75.3% and 74.8% (P = 0.97), respectively. Conclusion: Both SKOUT and GI Genius improved adenoma and polyp detection in real-world practice. SKOUT showed slightly higher ADR and APC, while GI Genius had marginally better PDR and APP. No statistically significant differences were observed, supporting comparable efficacy. These findings suggest either platform can enhance colonoscopy quality, with selection based on institutional needs and operator preference. Further prospective studies are needed to clarify potential advantages.