Assisted documentation as a new focus for artificial intelligence in endoscopy: the precedent of reliable withdrawal time and image reporting.

Journal: Endoscopy
PMID:

Abstract

BACKGROUND : Reliable documentation is essential for maintaining quality standards in endoscopy; however, in clinical practice, report quality varies. We developed an artificial intelligence (AI)-based prototype for the measurement of withdrawal and intervention times, and automatic photodocumentation. METHOD:  A multiclass deep learning algorithm distinguishing different endoscopic image content was trained with 10 557 images (1300 examinations, nine centers, four processors). Consecutively, the algorithm was used to calculate withdrawal time (AI prediction) and extract relevant images. Validation was performed on 100 colonoscopy videos (five centers). The reported and AI-predicted withdrawal times were compared with video-based measurement; photodocumentation was compared for documented polypectomies. RESULTS:  Video-based measurement in 100 colonoscopies revealed a median absolute difference of 2.0 minutes between the measured and reported withdrawal times, compared with 0.4 minutes for AI predictions. The original photodocumentation represented the cecum in 88 examinations compared with 98/100 examinations for the AI-generated documentation. For 39/104 polypectomies, the examiners' photographs included the instrument, compared with 68 for the AI images. Lastly, we demonstrated real-time capability (10 colonoscopies). CONCLUSION : Our AI system calculates withdrawal time, provides an image report, and is real-time ready. After further validation, the system may improve standardized reporting, while decreasing the workload created by routine documentation.

Authors

  • Thomas J Lux
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany.
  • Zita Saßmannshausen
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany.
  • Ioannis Kafetzis
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
  • Philipp Sodmann
    Institute of Bioinformatics, University Medicine Greifswald, Greifswald, Germany. DZHK (German Center for Cardiological Research), partner site Greifswald, Greifswald, Germany.
  • Katja Herold
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
  • Boban Sudarevic
    Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
  • Rudiger Schmitz
  • Wolfram G Zoller
    Department of Internal Medicine and Gastroenterology, Katharinenhospital, Stuttgart, Germany.
  • Alexander Meining
    Department of Gastroenterology, University of Würzburg, Würzburg, Germany.
  • Alexander Hann
    Department of Internal Medicine II, Interventional and Experimental Endoscopy (InExEn), University Hospital Wuerzburg, Würzburg, Germany.