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Mohan A, Asghar Z, Abid R, Subedi R, Kumari K, Kumar S, Majumder K, Bhurgri AI, Tejwaney U, Kumar S. Revolutionizing healthcare by use of artificial intelligence in esophageal carcinoma - a narrative review. Ann Med Surg (Lond) 2023; 85:4920-4927. [PMID: 37811030 PMCID: PMC10553069 DOI: 10.1097/ms9.0000000000001175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/05/2023] [Indexed: 10/10/2023] Open
Abstract
Esophageal cancer is a major cause of cancer-related mortality worldwide, with significant regional disparities. Early detection of precursor lesions is essential to improve patient outcomes. Artificial intelligence (AI) techniques, including deep learning and machine learning, have proved to be of assistance to both gastroenterologists and pathologists in the diagnosis and characterization of upper gastrointestinal malignancies by correlating with the histopathology. The primary diagnostic method in gastroenterology is white light endoscopic evaluation, but conventional endoscopy is partially inefficient in detecting esophageal cancer. However, other endoscopic modalities, such as narrow-band imaging, endocytoscopy, and endomicroscopy, have shown improved visualization of mucosal structures and vasculature, which provides a set of baseline data to develop efficient AI-assisted predictive models for quick interpretation. The main challenges in managing esophageal cancer are identifying high-risk patients and the disease's poor prognosis. Thus, AI techniques can play a vital role in improving the early detection and diagnosis of precursor lesions, assisting gastroenterologists in performing targeted biopsies and real-time decisions of endoscopic mucosal resection or endoscopic submucosal dissection. Combining AI techniques and endoscopic modalities can enhance the diagnosis and management of esophageal cancer, improving patient outcomes and reducing cancer-related mortality rates. The aim of this review is to grasp a better understanding of the application of AI in the diagnosis, treatment, and prognosis of esophageal cancer and how computer-aided diagnosis and computer-aided detection can act as vital tools for clinicians in the long run.
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Affiliation(s)
| | | | - Rabia Abid
- Liaquat College of Medicine and Dentistry
| | - Rasish Subedi
- Universal College of Medical Sciences, Siddharthanagar, Nepal
| | | | | | | | - Aqsa I. Bhurgri
- Shaheed Muhtarma Benazir Bhutto Medical University, Larkana, Pakistan
| | | | - Sarwan Kumar
- Department of Medicine, Chittagong Medical College, Chittagong, Bangladesh
- Wayne State University, Michigan, USA
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Huang JG, Tanpowpong P. Paediatric gastrointestinal endoscopy in the Asian-Pacific region: Recent advances in diagnostic and therapeutic techniques. World J Gastroenterol 2023; 29:2717-2732. [PMID: 37274071 PMCID: PMC10237107 DOI: 10.3748/wjg.v29.i18.2717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/12/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Abstract
There has been a rapid expansion in the knowledge of paediatric gastroenterology over the recent decade, with a fast-growing repertoire of diagnostic techniques and management strategies for a wide spectrum of childhood gastrointestinal (GI) diseases. Paediatric GI endoscopy is a core competency every paediatric gastroenterologist should possess, and represents one of the most common procedures performed in children for both diagnostic and therapeutic purposes. Yet there remains a dearth of literature on the utility and outcomes of paediatric GI endoscopy in the Asia-Pacific region. Data on the diagnostic value of paediatric GI endoscopy would be an important aspect of discussion, with the emergence of inflammatory bowel disease (IBD) and eosinophilic GI disease as increasingly common endoscopic diagnoses. Time-based trends in paediatric GI endoscopy do point towards more IBD and gastroesophageal reflux disease-related complications being diagnosed, with a declining incidence of GI bleeding. However, the real-world diagnostic value of endoscopy in Asia must be contextualised to the region-specific prevalence of paediatric GI diseases. Helicobacter pylori infection, particularly that of multidrug-resistant strains, remains a highly prevalent problem in specific regions. Paediatric functional GI disorders still account for the majority of childhood GI complaints in most centres, hence the diagnostic yield of endoscopy should be critically evaluated in the absence of alarm symptoms. GI therapeutic endoscopy is also occasionally required for children with ingested foreign bodies, intestinal polyposis or oesophageal strictures requiring dilation. Endoscopic haemostasis is a potentially life-saving skill in cases of massive GI bleeding typically from varices or peptic ulcers. Advanced endoscopic techniques such as capsule endoscopy and balloon-assisted enteroscopy have found traction, particularly in East Asian centres, as invaluable diagnostic and therapeutic tools in the management of IBD, obscure GI bleeding and intestinal polyposis. State of the art endoscopic diagnostics and therapeutics, including the use of artificial intelligence-aided endoscopy algorithms, real-time confocal laser endomicroscopy and peroral endoscopic myotomy, are expected to gain more utility in paediatrics. As paediatric gastroenterology matures as a subspecialty in Asia, it is essential current paediatric endoscopists and future trainees adhere to minimum practice standards, and keep abreast of the evolving trends in the diagnostic and therapeutic value of endoscopy. This review discusses the available published literature on the utility of paediatric GI endoscopy in Asia Pacific, with the relevant clinical outcomes.
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Affiliation(s)
- James Guoxian Huang
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore 119228, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine National University of Singapore, Singapore 119228, Singapore
| | - Pornthep Tanpowpong
- Department of Paediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Xue VW, Lei P, Cho WC. The potential impact of ChatGPT in clinical and translational medicine. Clin Transl Med 2023; 13:e1216. [PMID: 36856370 PMCID: PMC9976604 DOI: 10.1002/ctm2.1216] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Affiliation(s)
- Vivian Weiwen Xue
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of PharmacologyCarson International Cancer Center, Shenzhen University Health Science CenterShenzhenGuangdongChina
| | - Pinggui Lei
- Department of RadiologyThe Affiliated Hospital of Guizhou Medical UniversityGuiyangGuizhouChina
- School of Public HealthGuizhou Medical UniversityGuiyangGuizhouChina
| | - William C. Cho
- Department of Clinical OncologyQueen Elizabeth HospitalHong Kong SARChina
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4
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Huang YH, Xie C, Chou CY, Jin Y, Li W, Wang M, Lu Y, Liu Z. Subtyping intractable functional constipation in children using clinical and laboratory data in a classification model. Front Pediatr 2023; 11:1148753. [PMID: 37168808 PMCID: PMC10165123 DOI: 10.3389/fped.2023.1148753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/03/2023] [Indexed: 05/13/2023] Open
Abstract
Background Children with intractable functional constipation (IFC) who are refractory to traditional pharmacological intervention develop severe symptoms that can persist even in adulthood, resulting in a substantial deterioration in their quality of life. In order to better manage IFC patients, efficient subtyping of IFC into its three subtypes, normal transit constipation (NTC), outlet obstruction constipation (OOC), and slow transit constipation (STC), at early stages is crucial. With advancements in technology, machine learning can classify IFC early through the use of validated questionnaires and the different serum concentrations of gastrointestinal motility-related hormones. Method A hundred and one children with IFC and 50 controls were enrolled in this study. Three supervised machine-learning methods, support vector machine, random forest, and light gradient boosting machine (LGBM), were used to classify children with IFC into the three subtypes based on their symptom severity, self-efficacy, and quality of life which were quantified using certified questionnaires and their serum concentrations of the gastrointestinal hormones evaluated with enzyme-linked immunosorbent assay. The accuracy of machine learning subtyping was evaluated with respect to radiopaque markers. Results Of 101 IFC patients, 37 had NTC, 49 had OOC, and 15 had STC. The variables significant for IFC subtype classification, according to SelectKBest, were stool frequency, the satisfaction domain of the Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL), the emotional self-efficacy for Functional Constipation questionnaire (SEFCQ), motilin serum concentration, and vasoactive intestinal peptide serum concentration. Among the three models, the LGBM model demonstrated an accuracy of 83.8%, a precision of 84.5%, a recall of 83.6%, a f1-score of 83.4%, and an area under the receiver operating characteristic curve (AUROC) of 0.89 in discriminating IFC subtypes. Conclusion Using clinical characteristics measured by certified questionnaires and serum concentrations of the gastrointestinal hormones, machine learning can efficiently classify pediatric IFC into its three subtypes. Of the three models tested, the LGBM model is the most accurate model for the classification of IFC, with an accuracy of 83.8%, demonstrating that machine learning is an efficient tool for the management of IFC in children.
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Affiliation(s)
- Yi-Hsuan Huang
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Medical School, Nanjing University, Nanjing, China
| | - Chenjia Xie
- School of Electronic Science and Engineering, Nanjing University, Nanjing, China
| | - Chih-Yi Chou
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu Jin
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Medical School, Nanjing University, Nanjing, China
| | - Wei Li
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Meng Wang
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Lu
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Correspondence: Yan Lu Zhifeng Liu
| | - Zhifeng Liu
- Department of Gastroenterology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- Medical School, Nanjing University, Nanjing, China
- Correspondence: Yan Lu Zhifeng Liu
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Tziortziotis I, Laskaratos FM, Coda S. Role of Artificial Intelligence in Video Capsule Endoscopy. Diagnostics (Basel) 2021; 11:1192. [PMID: 34209029 PMCID: PMC8303156 DOI: 10.3390/diagnostics11071192] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
Capsule endoscopy (CE) has been increasingly utilised in recent years as a minimally invasive tool to investigate the whole gastrointestinal (GI) tract and a range of capsules are currently available for evaluation of upper GI, small bowel, and lower GI pathology. Although CE is undoubtedly an invaluable test for the investigation of small bowel pathology, it presents considerable challenges and limitations, such as long and laborious reading times, risk of missing lesions, lack of bowel cleansing score and lack of locomotion. Artificial intelligence (AI) seems to be a promising tool that may help improve the performance metrics of CE, and consequently translate to better patient care. In the last decade, significant progress has been made to apply AI in the field of endoscopy, including CE. Although it is certain that AI will find soon its place in day-to-day endoscopy clinical practice, there are still some open questions and barriers limiting its widespread application. In this review, we provide some general information about AI, and outline recent advances in AI and CE, issues around implementation of AI in medical practice and potential future applications of AI-aided CE.
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Affiliation(s)
- Ioannis Tziortziotis
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
| | - Faidon-Marios Laskaratos
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
| | - Sergio Coda
- Endoscopy Unit, Digestive Diseases Centre, Queen's Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford, London RM7 0AG, UK
- Photonics Group-Department of Physics, Imperial College London, Exhibition Rd, South Kensington, London SW7 2BX, UK
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Syed S, Ehsan L, Shrivastava A, Sengupta S, Khan M, Kowsari K, Guleria S, Sali R, Kant K, Kang SJ, Sadiq K, Iqbal NT, Cheng L, Moskaluk CA, Kelly P, Amadi BC, Ali SA, Moore SR, Brown DE. Artificial Intelligence-based Analytics for Diagnosis of Small Bowel Enteropathies and Black Box Feature Detection. J Pediatr Gastroenterol Nutr 2021; 72:833-841. [PMID: 33534362 PMCID: PMC8767179 DOI: 10.1097/mpg.0000000000003057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Striking histopathological overlap between distinct but related conditions poses a disease diagnostic challenge. There is a major clinical need to develop computational methods enabling clinicians to translate heterogeneous biomedical images into accurate and quantitative diagnostics. This need is particularly salient with small bowel enteropathies; environmental enteropathy (EE) and celiac disease (CD). We built upon our preliminary analysis by developing an artificial intelligence (AI)-based image analysis platform utilizing deep learning convolutional neural networks (CNNs) for these enteropathies. METHODS Data for the secondary analysis was obtained from three primary studies at different sites. The image analysis platform for EE and CD was developed using CNNs including one with multizoom architecture. Gradient-weighted class activation mappings (Grad-CAMs) were used to visualize the models' decision-making process for classifying each disease. A team of medical experts simultaneously reviewed the stain color normalized images done for bias reduction and Grad-CAMs to confirm structural preservation and biomedical relevance, respectively. RESULTS Four hundred and sixty-one high-resolution biopsy images from 150 children were acquired. Median age (interquartile range) was 37.5 (19.0-121.5) months with a roughly equal sex distribution; 77 males (51.3%). ResNet50 and shallow CNN demonstrated 98% and 96% case-detection accuracy, respectively, which increased to 98.3% with an ensemble. Grad-CAMs demonstrated models' ability to learn different microscopic morphological features for EE, CD, and controls. CONCLUSIONS Our AI-based image analysis platform demonstrated high classification accuracy for small bowel enteropathies which was capable of identifying biologically relevant microscopic features and emulating human pathologist decision-making process. Grad-CAMs illuminated the otherwise "black box" of deep learning in medicine, allowing for increased physician confidence in adopting these new technologies in clinical practice.
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Affiliation(s)
- Sana Syed
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Lubaina Ehsan
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Aman Shrivastava
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Data Science Institute, University of Virginia, Charlottesville, VA
| | - Saurav Sengupta
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Data Science Institute, University of Virginia, Charlottesville, VA
| | - Marium Khan
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Kamran Kowsari
- Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA
- University of California Los Angeles, Los Angeles, CA, USA
| | - Shan Guleria
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Rasoul Sali
- Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA
| | - Karan Kant
- Data Science Institute, University of Virginia, Charlottesville, VA
| | - Sung-Jun Kang
- Data Science Institute, University of Virginia, Charlottesville, VA
| | - Kamran Sadiq
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeha T. Iqbal
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Lin Cheng
- Pathology Department, Rush University Medical Center, Chicago, IL, USA
| | | | - Paul Kelly
- Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
- Blizard Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Beatrice C. Amadi
- Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
| | - S. Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sean R. Moore
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Donald E. Brown
- Systems and Information Engineering, University of Virginia, Charlottesville, VA, USA
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Rojas-Muñoz E, Couperus K, Wachs JP. The AI-Medic: an artificial intelligent mentor for trauma surgery. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2021. [DOI: 10.1080/21681163.2020.1835548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Edgar Rojas-Muñoz
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
| | - Kyle Couperus
- Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA, USA
| | - Juan P. Wachs
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
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Zhang W, Chen X, Wong KC. Noninvasive early diagnosis of intestinal diseases based on artificial intelligence in genomics and microbiome. J Gastroenterol Hepatol 2021; 36:823-831. [PMID: 33880763 DOI: 10.1111/jgh.15500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 12/15/2022]
Abstract
The maturing development in artificial intelligence (AI) and genomics has propelled the advances in intestinal diseases including intestinal cancer, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS). On the other hand, colorectal cancer is the second most deadly and the third most common type of cancer in the world according to GLOBOCAN 2020 data. The mechanisms behind IBD and IBS are still speculative. The conventional methods to identify colorectal cancer, IBD, and IBS are based on endoscopy or colonoscopy to identify lesions. However, it is invasive, demanding, and time-consuming for early-stage intestinal diseases. To address those problems, new strategies based on blood and/or human microbiome in gut, colon, or even feces were developed; those methods took advantage of high-throughput sequencing and machine learning approaches. In this review, we summarize the recent research and methods to diagnose intestinal diseases with machine learning technologies based on cell-free DNA and microbiome data generated by amplicon sequencing or whole-genome sequencing. Those methods play an important role in not only intestinal disease diagnosis but also therapy development in the near future.
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Affiliation(s)
- Weitong Zhang
- Department of Computer Science, City University of Hong Kong, Kowloon Tong, Hong Kong SAR
| | - Xingjian Chen
- Department of Computer Science, City University of Hong Kong, Kowloon Tong, Hong Kong SAR
| | - Ka-Chun Wong
- Department of Computer Science, City University of Hong Kong, Kowloon Tong, Hong Kong SAR.,Hong Kong Institute for Data Science, City University of Hong Kong, Kowloon Tong, Hong Kong SAR
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Wachs JP, Kirkpatrick AW, Tisherman SA. Procedural Telementoring in Rural, Underdeveloped, and Austere Settings: Origins, Present Challenges, and Future Perspectives. Annu Rev Biomed Eng 2021; 23:115-139. [PMID: 33770455 DOI: 10.1146/annurev-bioeng-083120-023315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Telemedicine is perhaps the most rapidly growing area in health care. Approximately 15 million Americans receive medical assistance remotely every year. Yet rural communities face significant challenges in securing subspecialist care. In the United States, 25% of the population resides in rural areas, where less than 15% of physicians work. Current surgery residency programs do not adequately prepare surgeons for rural practice. Telementoring, wherein a remote expert guides a less experienced caregiver, has been proposed to address this challenge. Nonetheless, existing mentoring technologies are not widely available to rural communities, due to a lack of infrastructure and mentor availability. For this reason, some clinicians prefer simpler and more reliable technologies. This article presents past and current telementoring systems, with a focus on rural settings, and proposes aset of requirements for such systems. We conclude with a perspective on the future of telementoring systems and the integration of artificial intelligence within those systems.
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Affiliation(s)
- Juan P Wachs
- School of Industrial Engineering, Purdue University, West Lafayette, Indiana 47907, USA;
| | - Andrew W Kirkpatrick
- Departments of Critical Care Medicine, Surgery, and Medicine; Snyder Institute for Chronic Diseases; and the Trauma Program, University of Calgary and Alberta Health Services, Calgary, Alberta T2N 2T9, Canada.,Tele-Mentored Ultrasound Supported Medical Interaction (TMUSMI) Research Group, Foothills Medical Centre, Calgary, Alberta T2N 2T9, Canada
| | - Samuel A Tisherman
- Department of Surgery and the Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
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van der Laan JJH, van der Waaij AM, Gabriëls RY, Festen EAM, Dijkstra G, Nagengast WB. Endoscopic imaging in inflammatory bowel disease: current developments and emerging strategies. Expert Rev Gastroenterol Hepatol 2021; 15:115-126. [PMID: 33094654 DOI: 10.1080/17474124.2021.1840352] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Developments in enhanced and magnified endoscopy have signified major advances in endoscopic imaging of ileocolonic pathology in inflammatory bowel disease (IBD). Artificial intelligence is increasingly being used to augment the benefits of these advanced techniques. Nevertheless, treatment of IBD patients is frustrated by high rates of non-response to therapy, while delayed detection and failures to detect neoplastic lesions impede successful surveillance. A possible solution is offered by molecular imaging, which adds functional imaging data to mucosal morphology assessment through visualizing biological parameters. Other label-free modalities enable visualization beyond the mucosal surface without the need of tracers. AREAS COVERED A literature search up to May 2020 was conducted in PubMed/MEDLINE in order to find relevant articles that involve the (pre-)clinical application of high-definition white light endoscopy, chromoendoscopy, artificial intelligence, confocal laser endomicroscopy, endocytoscopy, molecular imaging, optical coherence tomography, and Raman spectroscopy in IBD. EXPERT OPINION Enhanced and magnified endoscopy have enabled an improved assessment of the ileocolonic mucosa. Implementing molecular imaging in endoscopy could overcome the remaining clinical challenges by giving practitioners a real-time in vivo view of targeted biomarkers. Label-free modalities could help optimize the endoscopic assessment of mucosal healing and dysplasia detection in IBD patients.
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Affiliation(s)
- Jouke J H van der Laan
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
| | - Anne M van der Waaij
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
| | - Ruben Y Gabriëls
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
| | - Eleonora A M Festen
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
| | - Gerard Dijkstra
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
| | - Wouter B Nagengast
- Department of Gastroenterology and Hepatology, University Medical Centre Groningen , Groningen, The Netherlands
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12
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Cox CB, Laborda T, Kynes JM, Hiremath G. Evolution in the Practice of Pediatric Endoscopy and Sedation. Front Pediatr 2021; 9:687635. [PMID: 34336742 PMCID: PMC8317208 DOI: 10.3389/fped.2021.687635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/18/2021] [Indexed: 12/15/2022] Open
Abstract
The fields of pediatric gastrointestinal endoscopy and sedation are critically important to the diagnosis and treatment of gastrointestinal (GI) disease in children. Since its inception in the 1970s, pediatric endoscopy has benefitted from tremendous technological innovation related to the design of the endoscope and its associated equipment. Not only that, but expertise among pediatric gastroenterologists has moved the field forward to include a full complement of diagnostic and therapeutic endoscopic procedures in children. In this review, we discuss the remarkable history of pediatric endoscopy and highlight current limitations and future advances in the practice and technology of pediatric endoscopy and sedation.
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Affiliation(s)
- Conrad B Cox
- Division of Pediatric Gastroenterology Hepatology, and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States
| | - Trevor Laborda
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Utah Primary Children's Hospital, Salt Lake City, UT, United States.,Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, TX, United States
| | - J Matthew Kynes
- Department of Anesthesiology, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States
| | - Girish Hiremath
- Division of Pediatric Gastroenterology Hepatology, and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States
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Syed T, Doshi A, Guleria S, Syed S, Shah T. Artificial Intelligence and Its Role in Identifying Esophageal Neoplasia. Dig Dis Sci 2020; 65:3448-3455. [PMID: 33057945 PMCID: PMC8139616 DOI: 10.1007/s10620-020-06643-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022]
Abstract
Randomized trials have demonstrated that ablation of dysplastic Barrett's esophagus can reduce the risk of progression to cancer. Endoscopic resection for early stage esophageal adenocarcinoma and squamous cell carcinoma can significantly reduce postoperative morbidity compared to esophagectomy. Unfortunately, current endoscopic surveillance technologies (e.g., high-definition white light, electronic, and dye-based chromoendoscopy) lack sensitivity at identifying subtle areas of dysplasia and cancer. Random biopsies sample only approximately 5% of the esophageal mucosa at risk, and there is poor agreement among pathologists in identifying low-grade dysplasia. Machine-based deep learning medical image and video assessment technologies have progressed significantly in recent years, enabled in large part by advances in computer processing capabilities. In deep learning, sequential layers allow models to transform input data (e.g., pixels for imaging data) into a composite representation that allows for classification and feature identification. Several publications have attempted to use this technology to help identify dysplasia and early esophageal cancer. The aims of this reviews are as follows: (a) discussing limitations in our current strategies to identify esophageal dysplasia and cancer, (b) explaining the concepts behind deep learning and convolutional neural networks using language appropriate for clinicians without an engineering background, (c) systematically reviewing the literature for studies that have used deep learning to identify esophageal neoplasia, and (d) based on the systemic review, outlining strategies on further work necessary before these technologies are ready for "prime-time," i.e., use in routine clinical care.
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Affiliation(s)
- Taseen Syed
- Division of Gastroenterology, Virginia Commonwealth University Health System, 1200 East Marshall St, PO Box 980711, Richmond, VA, 23298, USA. .,Division of Gastroenterology, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA.
| | - Akash Doshi
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Shan Guleria
- Department of Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sana Syed
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of Virginia School of Medicine and UVA Child Health Research Center, Charlottesville, VA, USA
| | - Tilak Shah
- Division of Gastroenterology, Virginia Commonwealth University Health System, 1200 East Marshall St, PO Box 980711, Richmond, VA, 23298, USA.,Division of Gastroenterology, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
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Syed S, Stidham RW. Potential for Standardization and Automation for Pathology and Endoscopy in Inflammatory Bowel Disease. Inflamm Bowel Dis 2020; 26:1490-1497. [PMID: 32869844 PMCID: PMC7749192 DOI: 10.1093/ibd/izaa211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Indexed: 02/07/2023]
Abstract
Automated image analysis methods have shown potential for replicating expert interpretation of histology and endoscopy images, which traditionally require highly specialized and experienced reviewers. Inflammatory bowel disease (IBD) diagnosis, severity assessment, and treatment decision-making require multimodal expert data interpretation and integration, which could be significantly aided by applications of machine learning analyses. This review introduces fundamental concepts of machine learning for imaging analysis and highlights research and development of automated histology and endoscopy interpretation in IBD. Proof-of-concept studies strongly suggest that histologic and endoscopic images can be interpreted with similar accuracy as knowledge experts. Encouraging results support the potential of automating existing disease activity scoring instruments with high reproducibility, speed, and accessibility, therefore improving the standardization of IBD assessment. Though challenges surrounding ground truth definitions, technical barriers, and the need for extensive multicenter evaluation must be resolved before clinical implementation, automated image analysis is likely to both improve access to standardized IBD assessment and advance the fundamental concepts of how disease is measured.
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Affiliation(s)
- Sana Syed
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA, USA,Address correspondence to: Ryan W. Stidham, MD, MS, Assistant Professor of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, University of Michigan Medical School, 3912 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Ryan W Stidham
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA,Michigan Integrated Center for Health Analytics and Medical Prediction (MiCHAMP), University of Michigan, Ann Arbor, MI, USA
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Jin HY, Zhang M, Hu B. Techniques to integrate artificial intelligence systems with medical information in gastroenterology. Artif Intell Gastrointest Endosc 2020; 1:19-27. [DOI: 10.37126/aige.v1.i1.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal (GI) endoscopy is the central element in contemporary gastroenterology as it provides direct evidence to guide targeted therapy. To increase the accuracy of GI endoscopy and to reduce human-related errors, artificial intelligence (AI) has been applied in GI endoscopy, which has been proved to be effective in diagnosing and treating numerous diseases. Therefore, we review current research on the efficacy of AI-assisted GI endoscopy in order to assess its functions, advantages and how the design can be improved.
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Affiliation(s)
- Hong-Yu Jin
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Man Zhang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, Endoscopy Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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16
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Artificial intelligence and radiomics in nuclear medicine: potentials and challenges. Eur J Nucl Med Mol Imaging 2019; 46:2731-2736. [DOI: 10.1007/s00259-019-04593-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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