Artificial Intelligence in Gastrointestinal Endoscopy.

Artificial intelligence (AI) is rapidly integrating into modern technology and clinical practice. Although in its nascency, AI has become a hot topic of investigation for applications in clinical practice. Multiple fields of medicine have embraced the possibility of a future with AI assisting in diagnosis and pathology applications. In the field of gastroenterology, AI has been studied as a tool to assist in risk stratification, diagnosis, and pathologic identification. Specifically, AI has become of great interest in endoscopy as a technology with substantial potential to revolutionize the practice of a modern gastroenterologist. From cancer screening to automated report generation, AI has touched upon all aspects of modern endoscopy. Here, we review landmark AI developments in endoscopy. Starting with broad definitions to develop understanding, we will summarize the current state of AI research and its potential applications. With innovation developing rapidly, this article touches upon the remarkable advances in AI-assisted endoscopy since its initial evaluation at the turn of the millennium, and the potential impact these AI models may have on the modern clinical practice. As with any discussion of new technology, its limitations must also be understood to apply clinical AI tools successfully

An Efficient Approach for Polyps Detection in Endoscopic Videos Based on Faster R-CNN

Polyp has long been considered as one of the major etiologies to colorectal cancer which is a fatal disease around the world, thus early detection and recognition of polyps plays a crucial role in clinical routines. Accurate diagnoses of polyps through endoscopes operated by physicians becomes a challenging task not only due to the varying expertise of physicians, but also the inherent nature of endoscopic inspections. To facilitate this process, computer-aid techniques that emphasize fully-conventional image processing and novel machine learning enhanced approaches have been dedicatedly designed for polyp detection in endoscopic videos or images. Among all proposed algorithms, deep learning based methods take the lead in terms of multiple metrics in evolutions for algorithmic performance. In this work, a highly effective model, namely the faster region-based convolutional neural network (Faster R-CNN) is implemented for polyp detection. In comparison with the reported results of the state-of-the-art approaches on polyps detection, extensive experiments demonstrate that the Faster R-CNN achieves very competing results, and it is an efficient approach for clinical practice.Comment: 6 pages, 10 figures,2018 International Conference on Pattern Recognitio

Enhancing endoscopic navigation and polyp detection using artificial intelligence

Colorectal cancer (CRC) is one most common and deadly forms of cancer. It has a very high mortality rate if the disease advances to late stages however early diagnosis and treatment can be curative is hence essential to enhancing disease management. Colonoscopy is considered the gold standard for CRC screening and early therapeutic treatment. The effectiveness of colonoscopy is highly dependent on the operator’s skill, as a high level of hand-eye coordination is required to control the endoscope and fully examine the colon wall. Because of this, detection rates can vary between different gastroenterologists and technology have been proposed as solutions to assist disease detection and standardise detection rates. This thesis focuses on developing artificial intelligence algorithms to assist gastroenterologists during colonoscopy with the potential to ensure a baseline standard of quality in CRC screening. To achieve such assistance, the technical contributions develop deep learning methods and architectures for automated endoscopic image analysis to address both the detection of lesions in the endoscopic image and the 3D mapping of the endoluminal environment. The proposed detection models can run in real-time and assist visualization of different polyp types. Meanwhile the 3D reconstruction and mapping models developed are the basis for ensuring that the entire colon has been examined appropriately and to support quantitative measurement of polyp sizes using the image during a procedure. Results and validation studies presented within the thesis demonstrate how the developed algorithms perform on both general scenes and on clinical data. The feasibility of clinical translation is demonstrated for all of the models on endoscopic data from human participants during CRC screening examinations

Artificial intelligence and computer-aided diagnosis in colonoscopy: current evidence and future directions

Computer-aided diagnosis offers a promising solution to reduce variation in colonoscopy performance. Pooled miss rates for polyps are as high as 22%, and associated interval colorectal cancers after colonoscopy are of concern. Optical biopsy, whereby in-vivo classification of polyps based on enhanced imaging replaces histopathology, has not been incorporated into routine practice because it is limited by interobserver variability and generally only meets accepted standards in expert settings. Real-time decision-support software has been developed to detect and characterise polyps, and also to offer feedback on the technical quality of inspection. Some of the current algorithms, particularly with recent advances in artificial intelligence techniques, match human expert performance for optical biopsy. In this Review, we summarise the evidence for clinical applications of computer-aided diagnosis and artificial intelligence in colonoscopy

Colonoscopy polyp detection and classification: Dataset creation and comparative evaluations

Colorectal cancer (CRC) is one of the most common types of cancer with a high mortality rate. Colonoscopy is the preferred procedure for CRC screening and has proven to be effective in reducing CRC mortality. Thus, a reliable computer-aided polyp detection and classification system can significantly increase the effectiveness of colonoscopy. In this paper, we create an endoscopic dataset collected from various sources and annotate the ground truth of polyp location and classification results with the help of experienced gastroenterologists. The dataset can serve as a benchmark platform to train and evaluate the machine learning models for polyp classification. We have also compared the performance of eight state-of-the-art deep learning-based object detection models. The results demonstrate that deep CNN models are promising in CRC screening. This work can serve as a baseline for future research in polyp detection and classification

Assessing generalisability of deep learning-based polyp detection and segmentation methods through a computer vision challenge

Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, appearance, and location makes the detection of polyps challenging. Moreover, colonoscopy surveillance and removal of polyps are highly operator-dependent procedures and occur in a highly complex organ topology. There exists a high missed detection rate and incomplete removal of colonic polyps. To assist in clinical procedures and reduce missed rates, automated methods for detecting and segmenting polyps using machine learning have been achieved in past years. However, the major drawback in most of these methods is their ability to generalise to out-of-sample unseen datasets from different centres, populations, modalities, and acquisition systems. To test this hypothesis rigorously, we, together with expert gastroenterologists, curated a multi-centre and multi-population dataset acquired from six different colonoscopy systems and challenged the computational expert teams to develop robust automated detection and segmentation methods in a crowd-sourcing Endoscopic computer vision challenge. This work put forward rigorous generalisability tests and assesses the usability of devised deep learning methods in dynamic and actual clinical colonoscopy procedures. We analyse the results of four top performing teams for the detection task and five top performing teams for the segmentation task. Our analyses demonstrate that the top-ranking teams concentrated mainly on accuracy over the real-time performance required for clinical applicability. We further dissect the devised methods and provide an experiment-based hypothesis that reveals the need for improved generalisability to tackle diversity present in multi-centre datasets and routine clinical procedures

Applied Deep Learning to Identify and Localize Polyps from Endoscopic Images

Deep learning based neural networks have gained popularity for a variety of biomedical imaging applications. In the last few years several works have shown the use of these methods for colon cancer detection and the early results have been promising. These methods can potentially be utilized to assist doctor's and may help in identifying the number of lesions or abnormalities in a diagnosis session. From our literature survey we found out that there is a lack of publicly available labeled data. Thus, as part of this work, we have aimed at open sourcing a dataset which contains annotations of polyps and ulcers. This is the first dataset that's coming from India containing polyp and ulcer images. The dataset can be used for detection and classification tasks. We also evaluated our dataset with several popular deep learning object detection models that's trained on large publicly available datasets and found out empirically that the model trained on one dataset works well on our dataset that has data being captured in a different acquisition device

Automatic detection of crohn disease in wireless capsule endoscopic images using a deep convolutional neural network

The diagnosis of Crohn’s disease (CD) in the small bowel is generally performed by observing a very large number of images captured by capsule endoscopy (CE). This diagnostic technique entails a heavy workload for the specialists in terms of time spent reviewing the images. This paper presents a convolutional neural network capable of classifying the CE images to identify those ones affected by lesions indicative of the disease. The architecture of the proposed network was custom designed to solve this image classification problem. This allowed different design decisions to be made with the aim of improving its performance in terms of accuracy and processing speed compared to other state-of-the-art deep-learning-based reference architectures. The experimentation was carried out on a set of 15,972 images extracted from 31 CE videos of patients affected by CD, 7,986 of which showed lesions associated with the disease. The training, validation/selection and evaluation of the network was performed on 70%, 10% and 20% of the total images, respectively. The ROC curve obtained on the test image set has an area greater than 0.997, with points in a 95-99% sensitivity range associated with specificities of 99-96%. These figures are higher than those achieved by EfficientNet-B5, VGG-16, Xception or ResNet networks which also require an average processing time per image significantly higher than the one needed in the proposed architecture. Therefore, the network outlined in this paper is proving to be sufficiently promising to be considered for integration into tools used by specialists in their diagnosis of CD. In the sample of images analysed, the network was able to detect 99% of the images with lesions, filtering out for specialist review 96% of those with no signs of disease.Funding for open access charge: Universidad de Huelva / CBUA This work was part of a project funded under the 2014-2020 Andalusia ERDF Operational Programme (Project Reference: UHU-1257810- PO FEDER 2014-2020

Deep learning to find colorectal polyps in colonoscopy: A systematic literature review

Colorectal cancer has a great incidence rate worldwide, but its early detection significantly increases the survival rate. Colonoscopy is the gold standard procedure for diagnosis and removal of colorectal lesions with potential to evolve into cancer and computer-aided detection systems can help gastroenterologists to increase the adenoma detection rate, one of the main indicators for colonoscopy quality and predictor for colorectal cancer prevention. The recent success of deep learning approaches in computer vision has also reached this field and has boosted the number of proposed methods for polyp detection, localization and segmentation. Through a systematic search, 35 works have been retrieved. The current systematic review provides an analysis of these methods, stating advantages and disadvantages for the different categories used; comments seven publicly available datasets of colonoscopy images; analyses the metrics used for reporting and identifies future challenges and recommendations. Convolutional neural networks are the most used architecture together with an important presence of data augmentation strategies, mainly based on image transformations and the use of patches. End-to-end methods are preferred over hybrid methods, with a rising tendency. As for detection and localization tasks, the most used metric for reporting is the recall, while Intersection over Union is highly used in segmentation. One of the major concerns is the difficulty for a fair comparison and reproducibility of methods. Even despite the organization of challenges, there is still a need for a common validation framework based on a large, annotated and publicly available database, which also includes the most convenient metrics to report results. Finally, it is also important to highlight that efforts should be focused in the future on proving the clinical value of the deep learning based methods, by increasing the adenoma detection rate.This work was partially supported by PICCOLO project. This project has received funding from the European Union's Horizon2020 Research and Innovation Programme under grant agreement No. 732111. The sole responsibility of this publication lies with the author. The European Union is not responsible for any use that may be made of the information contained therein. The authors would also like to thank Dr. Federico Soria for his support on this manuscript and Dr. José Carlos Marín, from Hospital 12 de Octubre, and Dr. Ángel Calderón and Dr. Francisco Polo, from Hospital de Basurto, for the images in Fig. 4

Spatio-temporal classification for polyp diagnosis

Colonoscopy remains the gold standard investigation for colorectal cancer screening as it offers the opportunity to both detect and resect pre-cancerous polyps. Computer-aided polyp characterisation can determine which polyps need polypectomy and recent deep learning-based approaches have shown promising results as clinical decision support tools. Yet polyp appearance during a procedure can vary, making automatic predictions unstable. In this paper, we investigate the use of spatio-temporal information to improve the performance of lesions classification as adenoma or non-adenoma. Two methods are implemented showing an increase in performance and robustness during extensive experiments both on internal and openly available benchmark datasets