Improving the endoscopic recognition of early colorectal carcinoma using artificial intelligence: current evidence and future directions

Ayla Thijssen; Ramon-Michel Schreuder; Nikoo Dehghani; Marieke Schor; Peter H.N. de With; Fons van der Sommen; Jurjen J. Boonstra; Leon M.G. Moons; Erik J. Schoon

doi:10.1055/a-2403-3103

Endoscopy International Open, Table of Contents

CC BY 4.0 · Endosc Int Open 2024; 12(10): E1102-E1117
DOI: 10.1055/a-2403-3103

Review

Improving the endoscopic recognition of early colorectal carcinoma using artificial intelligence: current evidence and future directions

Ayla Thijssen

¹GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands (Ringgold ID: RIN5211)

²Department of Gastroenterology and Hepatology, Maastricht Universitair Medisch Centrum+, Maastricht, Netherlands (Ringgold ID: RIN199236)

,

Ramon-Michel Schreuder

³Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, Netherlands (Ringgold ID: RIN3168)

¹GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands (Ringgold ID: RIN5211)

,

Nikoo Dehghani

⁴Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands

,

Marieke Schor

⁵University Library, Department of Education and Support, Maastricht University, Maastricht, Netherlands (Ringgold ID: RIN5211)

,

Peter H.N. de With

⁴Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands

,

Fons van der Sommen

⁴Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands

,

Jurjen J. Boonstra

⁶Department of Gastroenterology and Hepatology, Leids Universitair Medisch Centrum, Leiden, Netherlands (Ringgold ID: RIN4501)

,

Leon M.G. Moons

⁷Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, Netherlands

,

Erik J. Schoon

³Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, Netherlands (Ringgold ID: RIN3168)

¹GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands (Ringgold ID: RIN5211)

› Author Affiliations

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.

Keywords

Endoscopy Lower GI Tract - Colorectal cancer - Polyps / adenomas / ... - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Quality and logistical aspects - Image and data processing, documentatiton

Full Text

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Supplementary Material

Supplementary Material