Real-time colorectal polyp detection using a novel computer-aided detection system (CADe): a feasibility study

Building Machine Learning Models in Gastrointestinal Endoscopy

The current landscape of machine learning models in GI endoscopy is fraught with considerable variability in methodologies and quality, posing challenges for validation and generalization. To ensure the effective integration of AI in clinical practice, it is crucial to develop and validate models rigorously across diverse and representative datasets. This involves standardizing reference standards, ensuring thorough external validation, using representative patient populations, and incorporating a range of image qualities. Addressing these methodological discrepancies will enhance the reliability and robustness of AI models, thereby facilitating their adoption and improving patient care in GI endoscopy.

Artificial intelligence for dysplasia detection during surveillance colonoscopy in patients with ulcerative colitis: A cross-sectional, non-inferiority, diagnostic test comparison study

BACKGROUND AND STUDY AIM

High-definition virtual chromoendoscopy, along with targeted biopsies, is recommended for dysplasia surveillance in ulcerative colitis patients at risk for colorectal cancer. Computer-aided detection (CADe) systems aim to improve colonic adenoma detection, however their efficacy in detecting polyps and adenomas in this context remains unclear. This study evaluates the CADe Discovery™ system's effectiveness in detecting colonic dysplasia in ulcerative colitis patients at risk for colorectal cancer.

PATIENTS AND METHODS

A prospective cross-sectional, non-inferiority, diagnostic test comparison study was conducted on ulcerative colitis patients undergoing colorectal cancer surveillance colonoscopy between January 2021 and April 2021. Patients underwent virtual chromoendoscopy (VCE) with iSCAN 1 and 3 with optical enhancement. One endoscopist, blinded to CADe Discovery™ system results, examined colon sections, while a second endoscopist concurrently reviewed CADe images. Suspicious areas detected by both techniques underwent resection. Proportions of dysplastic lesions and patients with dysplasia detected by VCE or CADe were calculated.

RESULTS

Fifty-two patients were included, and 48 lesions analyzed. VCE and CADe each detected 9 cases of dysplasia (21.4% and 20.0%, respectively; p=0.629) in 8 patients and 7 patients (15.4% vs. 13.5%, respectively; p=0.713). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for dysplasia detection using VCE or CADe were 90% and 90%, 13% and 5%, 21% and 2%, 83% and 67%, and 29.2% and 22.9%, respectively.

CONCLUSIONS

The CADe Discovery™ system shows similar diagnostic performance to VCE with iSCAN in detecting colonic dysplasia in ulcerative colitis patients at risk for colorectal cancer.

A semantic feature enhanced YOLOv5-based network for polyp detection from colonoscopy images

Colorectal cancer (CRC) is a common digestive system tumor with high morbidity and mortality worldwide. At present, the use of computer-assisted colonoscopy technology to detect polyps is relatively mature, but it still faces some challenges, such as missed or false detection of polyps. Therefore, how to improve the detection rate of polyps more accurately is the key to colonoscopy. To solve this problem, this paper proposes an improved YOLOv5-based cancer polyp detection method for colorectal cancer. The method is designed with a new structure called P-C3 incorporated into the backbone and neck network of the model to enhance the expression of features. In addition, a contextual feature augmentation module was introduced to the bottom of the backbone network to increase the receptive field for multi-scale feature information and to focus on polyp features by coordinate attention mechanism. The experimental results show that compared with some traditional target detection algorithms, the model proposed in this paper has significant advantages for the detection accuracy of polyp, especially in the recall rate, which largely solves the problem of missed detection of polyps. This study will contribute to improve the polyp/adenoma detection rate of endoscopists in the process of colonoscopy, and also has important significance for the development of clinical work.

Colorectal image analysis for polyp diagnosis

Colorectal polyp is an important early manifestation of colorectal cancer, which is significant for the prevention of colorectal cancer. Despite timely detection and manual intervention of colorectal polyps can reduce their chances of becoming cancerous, most existing methods ignore the uncertainties and location problems of polyps, causing a degradation in detection performance. To address these problems, in this paper, we propose a novel colorectal image analysis method for polyp diagnosis via PAM-Net. Specifically, a parallel attention module is designed to enhance the analysis of colorectal polyp images for improving the certainties of polyps. In addition, our method introduces the GWD loss to enhance the accuracy of polyp diagnosis from the perspective of polyp location. Extensive experimental results demonstrate the effectiveness of the proposed method compared with the SOTA baselines. This study enhances the performance of polyp detection accuracy and contributes to polyp detection in clinical medicine.

Application of artificial intelligence in endoscopic gastrointestinal tumors

With an increasing number of patients with gastrointestinal cancer, effective and accurate early diagnostic clinical tools are required provide better health care for patients with gastrointestinal cancer. Recent studies have shown that artificial intelligence (AI) plays an important role in the diagnosis and treatment of patients with gastrointestinal tumors, which not only improves the efficiency of early tumor screening, but also significantly improves the survival rate of patients after treatment. With the aid of efficient learning and judgment abilities of AI, endoscopists can improve the accuracy of diagnosis and treatment through endoscopy and avoid incorrect descriptions or judgments of gastrointestinal lesions. The present article provides an overview of the application status of various artificial intelligence in gastric and colorectal cancers in recent years, and the direction of future research and clinical practice is clarified from a clinical perspective to provide a comprehensive theoretical basis for AI as a promising diagnostic and therapeutic tool for gastrointestinal cancer.