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Thijssen A, Schreuder RM, Dehghani N, Schor M, de With PH, van der Sommen F, Boonstra JJ, Moons LM, Schoon EJ. Improving the endoscopic recognition of early colorectal carcinoma using artificial intelligence: current evidence and future directions. Endosc Int Open 2024; 12:E1102-E1117. [PMID: 39398448 PMCID: PMC11466514 DOI: 10.1055/a-2403-3103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/21/2024] [Indexed: 10/15/2024] Open
Abstract
Background and study aims Artificial intelligence (AI) has great potential to improve endoscopic recognition of early stage colorectal carcinoma (CRC). This scoping review aimed to summarize current evidence on this topic, provide an overview of the methodologies currently used, and guide future research. Methods A systematic search was performed following the PRISMA-Scr guideline. PubMed (including Medline), Scopus, Embase, IEEE Xplore, and ACM Digital Library were searched up to January 2024. Studies were eligible for inclusion when using AI for distinguishing CRC from colorectal polyps on endoscopic imaging, using histopathology as gold standard, reporting sensitivity, specificity, or accuracy as outcomes. Results Of 5024 screened articles, 26 were included. Computer-aided diagnosis (CADx) system classification categories ranged from two categories, such as lesions suitable or unsuitable for endoscopic resection, to five categories, such as hyperplastic polyp, sessile serrated lesion, adenoma, cancer, and other. The number of images used in testing databases varied from 69 to 84,585. Diagnostic performances were divergent, with sensitivities varying from 55.0% to 99.2%, specificities from 67.5% to 100% and accuracies from 74.4% to 94.4%. Conclusions This review highlights that using AI to improve endoscopic recognition of early stage CRC is an upcoming research field. We introduced a suggestions list of essential subjects to report in research regarding the development of endoscopy CADx systems, aiming to facilitate more complete reporting and better comparability between studies. There is a knowledge gap regarding real-time CADx system performance during multicenter external validation. Future research should focus on development of CADx systems that can differentiate CRC from premalignant lesions, while providing an indication of invasion depth.
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Affiliation(s)
- Ayla Thijssen
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
- Department of Gastroenterology and Hepatology, Maastricht Universitair Medisch Centrum+, Maastricht, Netherlands
| | - Ramon-Michel Schreuder
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
- Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, Netherlands
| | - Nikoo Dehghani
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marieke Schor
- University Library, Department of Education and Support, Maastricht University, Maastricht, Netherlands
| | - Peter H.N. de With
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Fons van der Sommen
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Jurjen J. Boonstra
- Department of Gastroenterology and Hepatology, Leids Universitair Medisch Centrum, Leiden, Netherlands
| | - Leon M.G. Moons
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Erik J. Schoon
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
- Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, Netherlands
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Rajasekar D, Theja G, Prusty MR, Chinara S. Efficient colorectal polyp segmentation using wavelet transformation and AdaptUNet: A hybrid U-Net. Heliyon 2024; 10:e33655. [PMID: 39040380 PMCID: PMC11261057 DOI: 10.1016/j.heliyon.2024.e33655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/06/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
The prevalence of colorectal cancer, primarily emerging from polyps, underscores the importance of their early detection in colonoscopy images. Due to the inherent complexity and variability of polyp appearances, the task stands difficult despite recent advances in medical technology. To tackle these challenges, a deep learning model featuring a customized U-Net architecture, AdaptUNet is proposed. Attention mechanisms and skip connections facilitate the effective combination of low-level details and high-level contextual information for accurate polyp segmentation. Further, wavelet transformations are used to extract useful features overlooked in conventional image processing. The model achieves benchmark results with a Dice coefficient of 0.9104, an Intersection over Union (IoU) coefficient of 0.8368, and a Balanced Accuracy of 0.9880 on the CVC-300 dataset. Additionally, it shows exceptional performance on other datasets, including Kvasir-SEG and Etis-LaribDB. Training was performed using the Hyper Kvasir segmented images dataset, further evidencing the model's ability to handle diverse data inputs. The proposed method offers a comprehensive and efficient implementation for polyp detection without compromising performance, thus promising an improved precision and reduction in manual labour for colorectal polyp detection.
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Affiliation(s)
- Devika Rajasekar
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, India
| | - Girish Theja
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, India
| | - Manas Ranjan Prusty
- Centre for Cyber Physical Systems, Vellore Institute of Technology, Chennai, India
| | - Suchismita Chinara
- Department of Computer Science and Engineering, National Institute of Technology, Rourkela, India
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Yang J, Chen L, Liu E, Wang B, Driman DK, Zhang Q, Ling C. Deep learning system for true- and pseudo-invasion in colorectal polyps. Sci Rep 2024; 14:426. [PMID: 38172166 PMCID: PMC10764718 DOI: 10.1038/s41598-023-50681-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
Over 15 million colonoscopies were performed yearly in North America, during which biopsies were taken for pathological examination to identify abnormalities. Distinguishing between true- and pseudo-invasion in colon polyps is critical in treatment planning. Surgical resection of the colon is often the treatment option for true invasion, whereas observation is recommended for pseudo-invasion. The task of identifying true- vs pseudo-invasion, however, could be highly challenging. There is no specialized software tool for this task, and no well-annotated dataset is available. In our work, we obtained (only) 150 whole-slide images (WSIs) from the London Health Science Centre. We built three deep neural networks representing different magnifications in WSIs, mimicking the workflow of pathologists. We also built an online tool for pathologists to annotate WSIs to train our deep neural networks. Results showed that our novel system classifies tissue types with 95.3% accuracy and differentiates true- and pseudo-invasions with 83.9% accuracy. The system's efficiency is comparable to an expert pathologist. Our system can also be easily adjusted to serve as a confirmatory or screening tool. Our system (available at http://ai4path.ca ) will lead to better, faster patient care and reduced healthcare costs.
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Affiliation(s)
- Joe Yang
- Department of Computer Science, Western University, London, N6A 3K7, Canada
| | - Lina Chen
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, M4N 3M5, Canada
| | - Eric Liu
- Department of Computer Science, Western University, London, N6A 3K7, Canada
| | - Boyu Wang
- Department of Computer Science, Western University, London, N6A 3K7, Canada
| | - David K Driman
- Department of Pathology and Laboratory Medicine, Western University, London, N6A 3K7, Canada
| | - Qi Zhang
- Department of Pathology and Laboratory Medicine, Western University, London, N6A 3K7, Canada.
| | - Charles Ling
- Department of Computer Science, Western University, London, N6A 3K7, Canada.
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Wang H, Liu X, Long J, Huang J, Lyu S, Zhao X, Zhao B, He Q, An Z, Hao J. Development and validation of a nomogram predictive model for colorectal adenoma with low-grade intraepithelial neoplasia using routine laboratory tests: A single-center case-control study in China. Heliyon 2023; 9:e20996. [PMID: 38027648 PMCID: PMC10660008 DOI: 10.1016/j.heliyon.2023.e20996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background Colorectal cancer (CRC) is the third most common cancer in the world and has a high mortality rate. Colorectal adenoma (CRA) is precancerous lesions of CRC. The purpose of the present study was to construct a nomogram predictive model for CRA with low-grade intraepithelial neoplasia (LGIN) in order to identify high-risk individuals, facilitating early diagnosis and treatment, and ultimately reducing the incidence of CRC. Methods We conducted a single-center case-control study. Based on the results of colonoscopy and pathology, 320 participants were divided into the CRA group and the control group, the demographic and laboratory test data were collected. A development cohort (n = 223) was used for identifying the risk factors for CRA with LGIN and to develop a predictive model, followed by an internal validation. An independent validation cohort (n = 97) was used for external validation. Receiver operating characteristic curve, calibration plot and decision curve analysis were used to evaluate discrimination ability, accuracy and clinical practicability of the model. Results Four predictors, namely sex, age, albumin and monocyte count, were included in the predictive model. In the development cohort, internal validation and external validation cohort, the area under the curve (AUC) of this risk predictive model were 0.946 (95%CI: 0.919-0.973), 0.909 (95 % CI: 0.869-0.940) and 0.928 (95%CI: 0.876-0.980), respectively, which demonstrated the model had a good discrimination ability. The calibration plots showed a good agreement and the decision curve analysis (DCA) suggested the predictive model had a high clinical net benefit. Conclusion The nomogram model exhibited good performance in predicting CRA with LGIN, which can aid in the early detection of high-risk patients, improve early treatment, and ultimately reduce the incidence of CRC.
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Affiliation(s)
- Huaguang Wang
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xinjuan Liu
- Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jiang Long
- Beijing Minimally Invasive Oncology Medical Center of Traditional Chinese and Western Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 101121, China
| | - Jincan Huang
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Shaocheng Lyu
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xin Zhao
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Baocheng Zhao
- Department of General Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Qiang He
- Department of Hepatobiliary Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Zhuoling An
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jianyu Hao
- Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
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Abraham A, Jose R, Ahmad J, Joshi J, Jacob T, Khalid AUR, Ali H, Patel P, Singh J, Toma M. Comparative Analysis of Machine Learning Models for Image Detection of Colonic Polyps vs. Resected Polyps. J Imaging 2023; 9:215. [PMID: 37888322 PMCID: PMC10607441 DOI: 10.3390/jimaging9100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/29/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Colon polyps are common protrusions in the colon's lumen, with potential risks of developing colorectal cancer. Early detection and intervention of these polyps are vital for reducing colorectal cancer incidence and mortality rates. This research aims to evaluate and compare the performance of three machine learning image classification models' performance in detecting and classifying colon polyps. (2) Methods: The performance of three machine learning image classification models, Google Teachable Machine (GTM), Roboflow3 (RF3), and You Only Look Once version 8 (YOLOv8n), in the detection and classification of colon polyps was evaluated using the testing split for each model. The external validity of the test was analyzed using 90 images that were not used to test, train, or validate the model. The study used a dataset of colonoscopy images of normal colon, polyps, and resected polyps. The study assessed the models' ability to correctly classify the images into their respective classes using precision, recall, and F1 score generated from confusion matrix analysis and performance graphs. (3) Results: All three models successfully distinguished between normal colon, polyps, and resected polyps in colonoscopy images. GTM achieved the highest accuracies: 0.99, with consistent precision, recall, and F1 scores of 1.00 for the 'normal' class, 0.97-1.00 for 'polyps', and 0.97-1.00 for 'resected polyps'. While GTM exclusively classified images into these three categories, both YOLOv8n and RF3 were able to detect and specify the location of normal colonic tissue, polyps, and resected polyps, with YOLOv8n and RF3 achieving overall accuracies of 0.84 and 0.87, respectively. (4) Conclusions: Machine learning, particularly models like GTM, shows promising results in ensuring comprehensive detection of polyps during colonoscopies.
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Affiliation(s)
- Adriel Abraham
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Rejath Jose
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Jawad Ahmad
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Jai Joshi
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Thomas Jacob
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Aziz-ur-rahman Khalid
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
| | - Hassam Ali
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA;
| | - Pratik Patel
- Department of Gastroenterology, Northwell Mather Hospital, Port Jefferson, NY 11777, USA (J.S.)
| | - Jaspreet Singh
- Department of Gastroenterology, Northwell Mather Hospital, Port Jefferson, NY 11777, USA (J.S.)
| | - Milan Toma
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 11568, USA; (A.A.); (R.J.); (J.A.); (J.J.); (T.J.); (A.-u.-r.K.)
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Aldughayfiq B, Ashfaq F, Jhanjhi NZ, Humayun M. YOLO-Based Deep Learning Model for Pressure Ulcer Detection and Classification. Healthcare (Basel) 2023; 11:healthcare11091222. [PMID: 37174764 PMCID: PMC10178524 DOI: 10.3390/healthcare11091222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/15/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
Pressure ulcers are significant healthcare concerns affecting millions of people worldwide, particularly those with limited mobility. Early detection and classification of pressure ulcers are crucial in preventing their progression and reducing associated morbidity and mortality. In this work, we present a novel approach that uses YOLOv5, an advanced and robust object detection model, to detect and classify pressure ulcers into four stages and non-pressure ulcers. We also utilize data augmentation techniques to expand our dataset and strengthen the resilience of our model. Our approach shows promising results, achieving an overall mean average precision of 76.9% and class-specific mAP50 values ranging from 66% to 99.5%. Compared to previous studies that primarily utilize CNN-based algorithms, our approach provides a more efficient and accurate solution for the detection and classification of pressure ulcers. The successful implementation of our approach has the potential to improve the early detection and treatment of pressure ulcers, resulting in better patient outcomes and reduced healthcare costs.
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Affiliation(s)
- Bader Aldughayfiq
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia
| | - Farzeen Ashfaq
- School of Computer Science, SCS, Taylor's University, Subang Jaya 47500, Malaysia
| | - N Z Jhanjhi
- School of Computer Science, SCS, Taylor's University, Subang Jaya 47500, Malaysia
| | - Mamoona Humayun
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia
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ELKarazle K, Raman V, Then P, Chua C. Detection of Colorectal Polyps from Colonoscopy Using Machine Learning: A Survey on Modern Techniques. SENSORS (BASEL, SWITZERLAND) 2023; 23:1225. [PMID: 36772263 PMCID: PMC9953705 DOI: 10.3390/s23031225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/08/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Given the increased interest in utilizing artificial intelligence as an assistive tool in the medical sector, colorectal polyp detection and classification using deep learning techniques has been an active area of research in recent years. The motivation for researching this topic is that physicians miss polyps from time to time due to fatigue and lack of experience carrying out the procedure. Unidentified polyps can cause further complications and ultimately lead to colorectal cancer (CRC), one of the leading causes of cancer mortality. Although various techniques have been presented recently, several key issues, such as the lack of enough training data, white light reflection, and blur affect the performance of such methods. This paper presents a survey on recently proposed methods for detecting polyps from colonoscopy. The survey covers benchmark dataset analysis, evaluation metrics, common challenges, standard methods of building polyp detectors and a review of the latest work in the literature. We conclude this paper by providing a precise analysis of the gaps and trends discovered in the reviewed literature for future work.
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Affiliation(s)
- Khaled ELKarazle
- School of Information and Communication Technologies, Swinburne University of Technology, Sarawak Campus, Kuching 93350, Malaysia
| | - Valliappan Raman
- Department of Artificial Intelligence and Data Science, Coimbatore Institute of Technology, Coimbatore 641014, India
| | - Patrick Then
- School of Information and Communication Technologies, Swinburne University of Technology, Sarawak Campus, Kuching 93350, Malaysia
| | - Caslon Chua
- Department of Computer Science and Software Engineering, Swinburne University of Technology, Melbourne 3122, Australia
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