Use of artificial intelligence in submucosal vessel detection during third-space endoscopy.

Journal: Endoscopy
Published Date:

Abstract

While artificial intelligence (AI) shows high potential in decision support for diagnostic gastrointestinal endoscopy, its role in therapeutic endoscopy remains unclear. Third-space endoscopic procedures pose the risk of intraprocedural bleeding. Therefore, we aimed to develop an AI algorithm for intraprocedural blood vessel detection.Using a test dataset of 101 standardized video clips containing 200 predefined submucosal blood vessels, 19 endoscopists were evaluated for vessel detection rate (VDR) and time (VDT) with and without support of an AI algorithm. Endoscopists were grouped according to experience in endoscopic submucosal dissection.With AI support, endoscopist VDR increased from 56.4% (95%CI CI 54.1-58.6) to 72.4% (95%CI CI 70.3-74.4). Endoscopist VDT dropped from 6.7 seconds (95%CI 6.2-7.1) to 5.2 seconds (95%CI 4.8-5.7). False-positive readings appeared in 4.5% of frames and were marked for a significantly shorter time than true positives (0.7 seconds [95%CI 0.55-0.87] vs. 6.0 seconds [95%CI 5.28-6.70]).AI improved the VDR and VDT of endoscopists during third-space endoscopy. While these data need to be corroborated by clinical trials, AI may prove to be an invaluable tool for improving safety and speed of endoscopic interventions.

Authors

  • Markus W Scheppach
    Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany.
  • Robert Mendel
    Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Germany.
  • Anna Muzalyova
    Internal Medicine III-Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.
  • David Rauber
    Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany.
  • Andreas Probst
    Medizinische Klinik III, Klinikum Augsburg, Germany.
  • Sandra Nagl
    Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany.
  • Christoph Römmele
    Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany.
  • Hon Chi Yip
    Division of Upper Gastrointestinal and Metabolic Surgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
  • Louis H S Lau
    Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
  • Stefan K Gölder
    Department of Internal Medicine I - Gastroenterology, Ostalb-Klinikum Aalen, Aalen, Germany.
  • Arthur Schmidt
    Department of Gastroenterology, Robert Bosch Krankenhaus, Stuttgart, Germany.
  • Konstantinos Kouladouros
    Department of Surgery, University Hospital Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
  • Mohamed Abdelhafez
    a II. Medizinische Klinik , Klinikum rechts der Isar der Technischen Universität München , Munich , Germany.
  • Benjamin M Walter
    Endoscopy Unit, Clinic for Internal Medicine I, University Hospital Ulm, Ulm, Germany.
  • Michael Meinikheim
    Internal Medicine III-Gastroenterology, University Hospital of Augsburg, Augsburg, Germany.
  • Philip W Y Chiu
    CUHK Jockey Club Minimally Invasive Surgical Skills Center, The Chinese University of Hong Kong, Shatin, Hong Kong. philipchiu@surgery.cuhk.edu.hk.
  • Christoph Palm
    Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Germany; Regensburg Center of Biomedical Engineering (RCBE), OTH Regensburg and Regensburg University, Germany.
  • Helmut Messmann
    Medizinische Klinik III, Klinikum Augsburg, Germany.
  • Alanna Ebigbo
    Medizinische Klinik III, Klinikum Augsburg, Germany.