Искусственный интеллект при колоректальном раке: обзор

The study objective: the study objective is to examine the use of artificial intelligence (AI) in the diagnosis, treatment, and prognosis of Colorectal Cancer (CRC) and discuss the future potential of AI in CRC. Material and Methods. The Web of Science, Scopus, PubMed, Medline, and eLIBRARY databases were used to search for the publications. A study on the application of Artificial Intelligence (AI) to the diagnosis, treatment, and prognosis of Colorectal Cancer (CRC) was discovered in more than 100 sources. In the review, data from 83 articles were incorporated. Results. The review article explores the use of artificial intelligence (AI) in medicine, specifically focusing on its applications in colorectal cancer (CRC). It discusses the stages of AI development for CRC, including molecular understanding, image-based diagnosis, drug design, and individualized treatment. The benefits of AI in medical image analysis are highlighted, improving diagnosis accuracy and inspection quality. Challenges in AI development are addressed, such as data standardization and the interpretability of machine learning algorithms. The potential of AI in treatment decision support, precision medicine, and prognosis prediction is discussed, emphasizing the role of AI in selecting optimal treatments and improving surgical precision. Ethical and regulatory considerations in integrating AI are mentioned, including patient trust, data security, and liability in AI-assisted surgeries. The review emphasizes the importance of an AI standard system, dataset standardization, and integrating clinical knowledge into AI algorithms. Overall, the article provides an overview of the current research on AI in CRC diagnosis, treatment, and prognosis, discussing its benefits, challenges, and future prospects in improving medical outcomes.Цель исследования - оценка возможностей использования искусственного интеллекта (ИИ) в диагностике, лечении и прогнозировании колоректального рака (КРР), а также обсуждение потенциала ИИ в лечении КРР. Материал и методы. Проведен поиск научных публикаций в поисковых системах Web of Science, Scopus, PubMed, Medline и eLIBRARY. Было просмотрено более 100 источников по применению ИИ для диагностики, лечения и прогнозирования КРР. В обзор включены данные из 83 статей. Результаты. Проведен анализ литературы, посвященной применению искусственного интеллекта в медицине, особое внимание уделено его использованию при колоректальном раке. Обсуждаются этапы развития ИИ при КРР, включая молекулярную верификацию, лучевую диагностику, разработку лекарств и индивидуальное лечение. Подчеркнуты преимущества ИИ в анализе медицинских изображений, таких как КТ, МРТ и ПЭТ, что повышает точность диагностики. Рассматриваются такие проблемы развития ИИ, как стандартизация данных и интерпретируемость алгоритмов машинного обучения. Подчеркивается роль ИИ в выборе оптимальной тактики лечения и повышении эффективности хирургического вмешательства. Учитываются этические и нормативные аспекты ИИ, включая доверие пациентов, безопасность данных и ответственность в проведении операций с использованием ИИ. Обсуждаются преимущества ИИ в диагностике, лечении и прогнозировании колоректального рака, проблемы и перспективы улучшения результатов лечения

Polyp detection on video colonoscopy using a hybrid 2D/3D CNN

Colonoscopy is the gold standard for early diagnosis and pre-emptive treatment of colorectal cancer by detecting and removing colonic polyps. Deep learning approaches to polyp detection have shown potential for enhancing polyp detection rates. However, the majority of these systems are developed and evaluated on static images from colonoscopies, whilst in clinical practice the treatment is performed on a real-time video feed. Non-curated video data remains a challenge, as it contains low-quality frames when compared to still, selected images often obtained from diagnostic records. Nevertheless, it also embeds temporal information that can be exploited to increase predictions stability. A hybrid 2D/3D convolutional neural network architecture for polyp segmentation is presented in this paper. The network is used to improve polyp detection by encompassing spatial and temporal correlation of the predictions while preserving real-time detections. Extensive experiments show that the hybrid method outperforms a 2D baseline. The proposed architecture is validated on videos from 46 patients and on the publicly available SUN polyp database. A higher performance and increased generalisability indicate that real-world clinical implementations of automated polyp detection can benefit from the hybrid algorithm and the inclusion of temporal information

Unravelling the effect of data augmentation transformations in polyp segmentation

Purpose: Data augmentation is a common technique to overcome the lack of large annotated databases, a usual situation when applying deep learning to medical imaging problems. Nevertheless, there is no consensus on which transformations to apply for a particular field. This work aims at identifying the effect of different transformations on polyp segmentation using deep learning. Methods: A set of transformations and ranges have been selected, considering image-based (width and height shift, rotation, shear, zooming, horizontal and vertical flip and elastic deformation), pixel-based (changes in brightness and contrast) and application-based (specular lights and blurry frames) transformations. A model has been trained under the same conditions without data augmentation transformations (baseline) and for each of the transformation and ranges, using CVC-EndoSceneStill and Kvasir-SEG, independently. Statistical analysis is performed to compare the baseline performance against results of each range of each transformation on the same test set for each dataset. Results: This basic method identifies the most adequate transformations for each dataset. For CVC-EndoSceneStill, changes in brightness and contrast significantly improve the model performance. On the contrary, Kvasir-SEG benefits to a greater extent from the image-based transformations, especially rotation and shear. Augmentation with synthetic specular lights also improves the performance. Conclusion: Despite being infrequently used, pixel-based transformations show a great potential to improve polyp segmentation in CVC-EndoSceneStill. On the other hand, image-based transformations are more suitable for Kvasir-SEG. Problem-based transformations behave similarly in both datasets. Polyp area, brightness and contrast of the dataset have an influence on these differences.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

MAST: Video Polyp Segmentation with a Mixture-Attention Siamese Transformer

Accurate segmentation of polyps from colonoscopy videos is of great significance to polyp treatment and early prevention of colorectal cancer. However, it is challenging due to the difficulties associated with modelling long-range spatio-temporal relationships within a colonoscopy video. In this paper, we address this challenging task with a novel Mixture-Attention Siamese Transformer (MAST), which explicitly models the long-range spatio-temporal relationships with a mixture-attention mechanism for accurate polyp segmentation. Specifically, we first construct a Siamese transformer architecture to jointly encode paired video frames for their feature representations. We then design a mixture-attention module to exploit the intra-frame and inter-frame correlations, enhancing the features with rich spatio-temporal relationships. Finally, the enhanced features are fed to two parallel decoders for predicting the segmentation maps. To the best of our knowledge, our MAST is the first transformer model dedicated to video polyp segmentation. Extensive experiments on the large-scale SUN-SEG benchmark demonstrate the superior performance of MAST in comparison with the cutting-edge competitors. Our code is publicly available at https://github.com/Junqing-Yang/MAST

DA-TransUNet: Integrating Spatial and Channel Dual Attention with Transformer U-Net for Medical Image Segmentation

Accurate medical image segmentation is critical for disease quantification and treatment evaluation. While traditional Unet architectures and their transformer-integrated variants excel in automated segmentation tasks. However, they lack the ability to harness the intrinsic position and channel features of image. Existing models also struggle with parameter efficiency and computational complexity, often due to the extensive use of Transformers. To address these issues, this study proposes a novel deep medical image segmentation framework, called DA-TransUNet, aiming to integrate the Transformer and dual attention block(DA-Block) into the traditional U-shaped architecture. Unlike earlier transformer-based U-net models, DA-TransUNet utilizes Transformers and DA-Block to integrate not only global and local features, but also image-specific positional and channel features, improving the performance of medical image segmentation. By incorporating a DA-Block at the embedding layer and within each skip connection layer, we substantially enhance feature extraction capabilities and improve the efficiency of the encoder-decoder structure. DA-TransUNet demonstrates superior performance in medical image segmentation tasks, consistently outperforming state-of-the-art techniques across multiple datasets. In summary, DA-TransUNet offers a significant advancement in medical image segmentation, providing an effective and powerful alternative to existing techniques. Our architecture stands out for its ability to improve segmentation accuracy, thereby advancing the field of automated medical image diagnostics. The codes and parameters of our model will be publicly available at https://github.com/SUN-1024/DA-TransUnet

Enhanced computer assisted detection of polyps in CT colonography

This thesis presents a novel technique for automatically detecting colorectal polyps in computed tomography colonography (CTC). The objective of the documented computer assisted diagnosis (CAD) technique is to deal with the issue of false positive detections without adversely affecting polyp detection sensitivity. The thesis begins with an overview of CTC and a review of the associated research areas, with particular attention given to CAD-CTC. This review identifies excessive false positive detections as a common problem associated with current CAD-CTC techniques. Addressing this problem constitutes the major contribution of this thesis. The documented CAD-CTC technique is trained with, and evaluated using, a series of clinical CTC data sets These data sets contain polyps with a range of different sizes and morphologies. The results presented m this thesis indicate the validity of the developed CAD-CTC technique and demonstrate its effectiveness m accurately detecting colorectal polyps while significantly reducing the number of false positive detections

Towards real-world clinical colonoscopy deep learning models for video-based bowel preparation and generalisable polyp segmentation

Colorectal cancer is the most prevalence type of cancers within the digestive system. Early screening and removal of precancerous growths in the colon decrease mortality rate. The golden standard screening type for colon is colonoscopy which is conducted by a medical expert (i.e., colonoscopist). Nevertheless, due to human biases, fatigue, and experience level of the colonoscopist, colorectal cancer missing rate is negatively affected. Artificial intelligence (AI) methods hold immense promise not just in automating colonoscopy tasks but also enhancing the performance of colonoscopy screening in general. The recent development of intense computational GPUs enabled a computational-demanding AI method (i.e., deep learning) to be utilised in various medical applications. However, given the gap between the clinical-practice and the proposed deep learning models in the literature, the actual effectiveness of such methods is questionable. Hence, this thesis highlights such gaps that arises from the separation between the theoretical and practical aspect of deep learning methods applied to colonoscopy. The aim is to evaluate the current state of deep learning models applied in colonoscopy from a clinical angle, and accordingly propose better evaluation strategies and deep learning models. The aim is translated into three distinct objectives. The first objective is to develop a systematic evaluation method to assess deep learning models from a clinical perspective. The second objective is to develop a novel deep learning architecture that leverages spatial information within colonoscopy videos to enhance the effectiveness of deep learning models on real-clinical environments. The third objective is to enhance the generalisability of deep learning models on unseen test images by developing a novel deep learning framework. To translate these objectives into practice, two critical colonoscopy tasks, namely, automatic bowel preparation and polyp segmentation are attacked. In both tasks, subtle overestimations are found in the literature and discussed in the thesis theoretically and demonstrated empirically. These overestimations are induced by improper validation sets that would not appear or represent the real-world clinical environment. Arbitrary dividing colonoscopy datasets to do deep learning evaluation can result in producing similar distributions, hence, achieving unrealistic results. Accordingly, these factors are considered in the thesis to avoid such subtle overestimation. For the automatic bowel preparation task, colonoscopy videos that closely resemble clinical settings are considered as input and accordingly it necessitates the design of the proposed model as well as evaluation experiments. The proposed model’s architecture is designed to utilise both temporal and spatial information within colonoscopy videos using Gated Recurrent Unit (GRU) and a proposed Multiplexer unit, respectively. Meanwhile for the polyp segmentation task, the efficiency of current deep learning models is tested in terms of their generalisation capabilities using unseen test sets from different medical centres. The proposed framework consists of two connected models. The first model is responsible for gradually transforming textures of input images and arbitrary change their colours. Meanwhile the second model is a segmentation model that outlines polyp regions. Exposing the segmentation model to such transformed images acquires the segmentation model texture/colour invariant properties, hence, enhances the generalisability of the segmentation model. In this thesis, rigorous experiments are conducted to evaluate the proposed models against the state-of-the-art models. The yielded results indicate that the proposed models outperformed the state-of-the-art models under different settings

Polar Contrast Attention and Skip Cross-channel Aggregation for Efficient Learning in U-Net

Peer reviewe

Towards real-world clinical colonoscopy deep learning models for video-based bowel preparation and generalisable polyp segmentation

Colorectal cancer is the most prevalence type of cancers within the digestive system. Early screening and removal of precancerous growths in the colon decrease mortality rate. The golden standard screening type for colon is colonoscopy which is conducted by a medical expert (i.e., colonoscopist). Nevertheless, due to human biases, fatigue, and experience level of the colonoscopist, colorectal cancer missing rate is negatively affected. Artificial intelligence (AI) methods hold immense promise not just in automating colonoscopy tasks but also enhancing the performance of colonoscopy screening in general. The recent development of intense computational GPUs enabled a computational-demanding AI method (i.e., deep learning) to be utilised in various medical applications. However, given the gap between the clinical-practice and the proposed deep learning models in the literature, the actual effectiveness of such methods is questionable. Hence, this thesis highlights such gaps that arises from the separation between the theoretical and practical aspect of deep learning methods applied to colonoscopy. The aim is to evaluate the current state of deep learning models applied in colonoscopy from a clinical angle, and accordingly propose better evaluation strategies and deep learning models. The aim is translated into three distinct objectives. The first objective is to develop a systematic evaluation method to assess deep learning models from a clinical perspective. The second objective is to develop a novel deep learning architecture that leverages spatial information within colonoscopy videos to enhance the effectiveness of deep learning models on real-clinical environments. The third objective is to enhance the generalisability of deep learning models on unseen test images by developing a novel deep learning framework. To translate these objectives into practice, two critical colonoscopy tasks, namely, automatic bowel preparation and polyp segmentation are attacked. In both tasks, subtle overestimations are found in the literature and discussed in the thesis theoretically and demonstrated empirically. These overestimations are induced by improper validation sets that would not appear or represent the real-world clinical environment. Arbitrary dividing colonoscopy datasets to do deep learning evaluation can result in producing similar distributions, hence, achieving unrealistic results. Accordingly, these factors are considered in the thesis to avoid such subtle overestimation. For the automatic bowel preparation task, colonoscopy videos that closely resemble clinical settings are considered as input and accordingly it necessitates the design of the proposed model as well as evaluation experiments. The proposed model’s architecture is designed to utilise both temporal and spatial information within colonoscopy videos using Gated Recurrent Unit (GRU) and a proposed Multiplexer unit, respectively. Meanwhile for the polyp segmentation task, the efficiency of current deep learning models is tested in terms of their generalisation capabilities using unseen test sets from different medical centres. The proposed framework consists of two connected models. The first model is responsible for gradually transforming textures of input images and arbitrary change their colours. Meanwhile the second model is a segmentation model that outlines polyp regions. Exposing the segmentation model to such transformed images acquires the segmentation model texture/colour invariant properties, hence, enhances the generalisability of the segmentation model. In this thesis, rigorous experiments are conducted to evaluate the proposed models against the state-of-the-art models. The yielded results indicate that the proposed models outperformed the state-of-the-art models under different settings