Classification Of Colorectal Polyps Research Articles

Advancements in the use of AI in the diagnosis and management of inflammatory bowel disease.

Inflammatory bowel disease (IBD) causes chronic inflammation of the colon and digestive tract, and it can be classified as Crohn's disease (CD) and Ulcerative colitis (UC). IBD is more prevalent in Europe and North America, however, since the beginning of the 21st century it has been increasing in South America, Asia, and Africa, leading to its consideration as a worldwide problem. Optical colonoscopy is one of the crucial tests in diagnosing and assessing the progression and prognosis of IBD, as it allows a real-time optical visualization of the colonic wall and ileum and allows for the collection of tissue samples. The accuracy of colonoscopy procedures depends on the expertise and ability of the endoscopists. Therefore, algorithms based on Deep Learning (DL) and Convolutional Neural Networks (CNN) for colonoscopy images and videos are growing in popularity, especially for the detection and classification of colorectal polyps. The performance of this system is dependent on the quality and quantity of the data used for training. There are several datasets publicly available for endoscopy images and videos, but most of them are solely specialized in polyps. The use of DL algorithms to detect IBD is still in its inception, most studies are based on assessing the severity of UC. As artificial intelligence (AI) grows in popularity there is a growing interest in the use of these algorithms for diagnosing and classifying the IBDs and managing their progression. To tackle this, more annotated colonoscopy images and videos will be required for the training of new and more reliable AI algorithms. This article discusses the current challenges in the early detection of IBD, focusing on the available AI algorithms, and databases, and the challenges ahead to improve the detection rate.

An effective colorectal polyp classification for histopathological images based on supervised contrastive learning

Early detection of colon adenomatous polyps is pivotal in reducing colon cancer risk. In this context, accurately distinguishing between adenomatous polyp subtypes, especially tubular and tubulovillous, from hyperplastic variants is crucial. This study introduces a cutting-edge computer-aided diagnosis system optimized for this task. Our system employs advanced Supervised Contrastive learning to ensure precise classification of colon histopathology images. Significantly, we have integrated the Big Transfer model, which has gained prominence for its exemplary adaptability to visual tasks in medical imaging. Our novel approach discerns between in-class and out-of-class images, thereby elevating its discriminatory power for polyp subtypes. We validated our system using two datasets: a specially curated one and the publicly accessible UniToPatho dataset. The results reveal that our model markedly surpasses traditional deep convolutional neural networks, registering classification accuracies of 87.1% and 70.3% for the custom and UniToPatho datasets, respectively. Such results emphasize the transformative potential of our model in polyp classification endeavors.

Semi-supervised generative adversarial networks for improved colorectal polyp classification using histopathological images

Early and accurate detection of dysplasia in colorectal polyps can improve prognosis and increase survival chances. Recently, automated learning-based approaches using histopathological images have been adopted for improved classification of polyps. The supervised learning approaches do not provide a reliable classification performance due to limited annotated samples. But, in unsupervised learning, some hidden features are extracted from the unlabeled data which may not be effective in discriminating the complex patterns of the dataset. A generative adversarial network (GAN) is proposed in this work based on a semi-supervised framework for colorectal polyp classification using histopathological images. Our framework learns the discriminating features in an adversarial manner from the limited labeled and huge unlabeled data. In the supervised mode, the discriminator of the proposed model is trained to classify the real histopathological images, whereas, in the unsupervised mode, it tries to discriminate between real and fake images, similar to the classical GAN network. By training in unsupervised mode, the discriminator can identify and extract the subtle features from unlabeled images, to develop a generalized robust model. Our technique yielded classification accuracies of 87.50% and 76.25% using 25% and 50% majority voting schemes, respectively, on the UniToPatho dataset.

A Systematic Review and Meta-analysis of Convolutional Neural Network in the Diagnosis of Colorectal Polyps and Cancer.

Convolutional neural networks are a class of deep neural networks used for different clinical purposes, including improving the detection rate of colorectal lesions. This systematic review and meta-analysis aimed to assess the performance of convolutional neural network-based models in the detection or classification of colorectal polyps and colorectal cancer. A systematic search was performed in MEDLINE, SCOPUS, Web of Science, and other related databases. The performance measures of the convolutional neural network models in the detection of colorectal polyps and colorectal cancer were calculated in the 2 scenarios of the best and worst accuracy. Stata and R software were used for conducting the meta-analysis. From 3368 searched records, 24 primary studies were included. The sensitivity and specificity of convolutional neural network models in predicting colorectal polyps in worst and best scenarios ranged from 84.7% to 91.6% and from 86.0% to 93.8%, respectively. These values in predicting colorectal cancer varied between 93.2% and 94.1% and between 94.6% and 97.7%. The positive and negative likelihood ratios varied between 6.2 and 14.5 and 0.09 and 0.17 in these scenarios, respectively, in predicting colorectal polyps, and 17.1-41.2 and 0.07-0.06 in predicting colorectal polyps. The diagnostic odds ratio and accuracy measures of convolutional neural network models in predicting colorectal polyps in worst and best scenarios ranged between 36% and 162% and between 80.5% and 88.6%, respectively. These values in predicting colorectal cancer in the worst and the best scenarios varied between 239.63% and 677.47% and between 88.2% and 96.4%. The area under the receiver operating characteristic varied between 0.92 and 0.97 in the worst and the best scenarios in colorectal polyps, respectively, and between 0.98 and 0.99 in colorectal polyps prediction. Convolutional neural network-based models showed an acceptable accuracy in detecting colorectal polyps and colorectal cancer.

Colorectal polyp classification and management of complex polyps for surgeon endoscopists.

SummaryIncreasing familiarity with advanced endoscopic excision techniques allows for more colorectal lesions to be removed without major surgery. Endoscopic excision with negative margins is adequate for most polyps and low-risk T1 cancers. The use of modern polyp classification techniques based on size, morphology and pit pattern by an experienced endoscopist allow for an optical diagnosis of these lesions and can predict, with high accuracy, which lesions contain malignant disease and the level of invasion. A surgeon endoscopist must be able to recognize which complex polyps can be resected with advanced polypectomy techniques and which require upfront surgery. We aimed to provide an overview of polyp classification techniques to help surgeons select the correct treatment algorithm for advanced colorectal lesions based on their visual characteristics at index endoscopy.

Improved classification of colorectal polyps on histopathological images with ensemble learning and stain normalization

Background and Objective: Early detection of colon adenomatous polyps is critically important because correct detection of it significantly reduces the potential of developing colon cancers in the future. The key challenge in the detection of adenomatous polyps is differentiating it from its visually similar counterpart, non-adenomatous tissues. Currently, it solely depends on the experience of the pathologist. To assist the pathologists, the objective of this work is to provide a novel non-knowledge-based Clinical Decision Support System (CDSS) for improved detection of adenomatous polyps on colon histopathology images.Methods: The domain shift problem arises when the train and test data are coming from different distributions of diverse settings and unequal color levels. This problem, which can be tackled by stain normalization techniques, restricts the machine learning models to attain higher classification accuracies. In this work, the proposed method integrates stain normalization techniques with ensemble of competitively accurate, scalable and robust variants of CNNs, ConvNexts. The improvement is empirically analyzed for five widely employed stain normalization techniques. The classification performance of the proposed method is evaluated on three datasets comprising more than 10k colon histopathology images.Results: The comprehensive experiments demonstrate that the proposed method outperforms the state-of-the-art deep convolutional neural network based models by attaining 95% classification accuracy on the curated dataset, and 91.1% and 90% on EBHI and UniToPatho public datasets, respectively.Conclusions: These results show that the proposed method can accurately classify colon adenomatous polyps on histopathology images. It retains remarkable performance scores even for different datasets coming from different distributions. This indicates that the model has a notable generalization ability.

Multi-Classification of Polyps in Colonoscopy Images Based on an Improved Deep Convolutional Neural Network

Achieving accurate classification of colorectal polyps during colonoscopy can avoid unnecessary endoscopic biopsy or resection. This study aimed to develop a deep learning model that can automatically classify colorectal polyps histologically on white-light and narrow-band imaging (NBI) colonoscopy images based on World Health Organization (WHO) and Workgroup serrAted polypS and Polyposis (WASP) classification criteria for colorectal polyps. White-light and NBI colonoscopy images of colorectal polyps exhibiting pathological results were firstly collected and classified into four categories: conventional adenoma, hyperplastic polyp, sessile serrated adenoma/polyp (SSAP) and normal, among which conventional adenoma could be further divided into three sub-categories of tubular adenoma, villous adenoma and villioustublar adenoma, subsequently the images were re-classified into six categories. In this paper, we proposed a novel convolutional neural network termed Polyp-DedNet for the four- and six-category classification tasks of colorectal polyps. Based on the existing classification network ResNet50, Polyp-DedNet adopted dilated convolution to retain more high-dimensional spatial information and an Efficient Channel Attention (ECA) module to improve the classification performance further. To eliminate gridding artifacts caused by dilated convolutions, traditional convolutional layers were used instead of the max pooling layer, and two convolutional layers with progressively decreasing dilation were added at the end of the network. Due to the inevitable imbalance of medical image data, a regularization method DropBlock and a Class-Balanced (CB) Loss were performed to prevent network overfitting. Furthermore, the 5-fold cross-validation was adopted to estimate the performance of Polyp-DedNet for the multi-classification task of colorectal polyps. Mean accuracies of the proposed Polyp-DedNet for the four- and six-category classifications of colorectal polyps were 89.91% ± 0.92% and 85.13% ± 1.10%, respectively. The metrics of precision, recall and F1-score were also improved by 1%~2% compared to the baseline ResNet50. The proposed Polyp-DedNet presented state-of-the-art performance for colorectal polyp classifying on white-light and NBI colonoscopy images, highlighting its considerable potential as an AI-assistant system for accurate colorectal polyp diagnosis in colonoscopy.

An ensemble framework of deep neural networks for colorectal polyp classification

An ensemble framework of deep neural networks for colorectal polyp classification

Vector textures derived from higher order derivative domains for classification of colorectal polyps

Textures have become widely adopted as an essential tool for lesion detection and classification through analysis of the lesion heterogeneities. In this study, higher order derivative images are being employed to combat the challenge of the poor contrast across similar tissue types among certain imaging modalities. To make good use of the derivative information, a novel concept of vector texture is firstly introduced to construct and extract several types of polyp descriptors. Two widely used differential operators, i.e., the gradient operator and Hessian operator, are utilized to generate the first and second order derivative images. These derivative volumetric images are used to produce two angle-based and two vector-based (including both angle and magnitude) textures. Next, a vector-based co-occurrence matrix is proposed to extract texture features which are fed to a random forest classifier to perform polyp classifications. To evaluate the performance of our method, experiments are implemented over a private colorectal polyp dataset obtained from computed tomographic colonography. We compare our method with four existing state-of-the-art methods and find that our method can outperform those competing methods over 4%-13% evaluated by the area under the receiver operating characteristics curves.

A deep ensemble learning method for colorectal polyp classification with optimized network parameters

Colorectal Cancer (CRC), a leading cause of cancer-related deaths, can be abated by timely polypectomy. Computer-aided classification of polyps helps endoscopists to resect timely without submitting the sample for histology. Deep learning-based algorithms are promoted for computer-aided colorectal polyp classification. However, the existing methods do not accommodate any information on hyperparametric settings essential for model optimisation. Furthermore, unlike the polyp types, i.e., hyperplastic and adenomatous, the third type, serrated adenoma, is difficult to classify due to its hybrid nature. Moreover, automated assessment of polyps is a challenging task due to the similarities in their patterns; therefore, the strength of individual weak learners is combined to form a weighted ensemble model for an accurate classification model by establishing the optimised hyperparameters. In contrast to existing studies on binary classification, multiclass classification require evaluation through advanced measures. This study compared six existing Convolutional Neural Networks in addition to transfer learning and opted for optimum performing architecture only for ensemble models. The performance evaluation on UCI and PICCOLO dataset of the proposed method in terms of accuracy (96.3%, 81.2%), precision (95.5%, 82.4%), recall (97.2%, 81.1%), F1-score (96.3%, 81.3%) and model reliability using Cohen’s Kappa Coefficient (0.94, 0.62) shows the superiority over existing models. The outcomes of experiments by other studies on the same dataset yielded 82.5% accuracy with 72.7% recall by SVM and 85.9% accuracy with 87.6% recall by other deep learning methods. The proposed method demonstrates that a weighted ensemble of optimised networks along with data augmentation significantly boosts the performance of deep learning-based CAD.

Artificial intelligence-assisted colonoscopy: A review of current state of practice and research.

Colonoscopy is an effective screening procedure in colorectal cancer prevention programs; however, colonoscopy practice can vary in terms of lesion detection, classification, and removal. Artificial intelligence (AI)-assisted decision support systems for endoscopy is an area of rapid research and development. The systems promise improved detection, classification, screening, and surveillance for colorectal polyps and cancer. Several recently developed applications for AI-assisted colonoscopy have shown promising results for the detection and classification of colorectal polyps and adenomas. However, their value for real-time application in clinical practice has yet to be determined owing to limitations in the design, validation, and testing of AI models under real-life clinical conditions. Despite these current limitations, ambitious attempts to expand the technology further by developing more complex systems capable of assisting and supporting the endoscopist throughout the entire colonoscopy examination, including polypectomy procedures, are at the concept stage. However, further work is required to address the barriers and challenges of AI integration into broader colonoscopy practice, to navigate the approval process from regulatory organizations and societies, and to support physicians and patients on their journey to accepting the technology by providing strong evidence of its accuracy and safety. This article takes a closer look at the current state of AI integration into the field of colonoscopy and offers suggestions for future research.

Evaluation of an Artificial Intelligence–Augmented Digital System for Histologic Classification of Colorectal Polyps

Colorectal polyps are common, and their histopathologic classification is used in the planning of follow-up surveillance. Substantial variation has been observed in pathologists' classification of colorectal polyps, and improved assessment by pathologists may be associated with reduced subsequent underuse and overuse of colonoscopy. To compare standard microscopic assessment with an artificial intelligence (AI)-augmented digital system that annotates regions of interest within digitized polyp tissue and predicts polyp type using a deep learning model to assist pathologists in colorectal polyp classification. In this diagnostic study conducted at a tertiary academic medical center and a community hospital in New Hampshire, 100 slides with colorectal polyp samples were read by 15 pathologists using a microscope and an AI-augmented digital system, with a washout period of at least 12 weeks between use of each modality. The study was conducted from February 10 to July 10, 2020. Accuracy and time of evaluation were used to compare pathologists' performance when a microscope was used with their performance when the AI-augmented digital system was used. Outcomes were compared using paired t tests and mixed-effects models. In assessments of 100 slides with colorectal polyp specimens, use of the AI-augmented digital system significantly improved pathologists' classification accuracy compared with microscopic assessment from 73.9% (95% CI, 71.7%-76.2%) to 80.8% (95% CI, 78.8%-82.8%) (P < .001). The overall difference in the evaluation time per slide between the digital system (mean, 21.7 seconds; 95% CI, 20.8-22.7 seconds) and microscopic examination (mean, 13.0 seconds; 95% CI, 12.4-13.5 seconds) was -8.8 seconds (95% CI, -9.8 to -7.7 seconds), but this difference decreased as pathologists became more familiar and experienced with the digital system; the difference between the time of evaluation on the last set of 20 slides for all pathologists when using the microscope and the digital system was 4.8 seconds (95% CI, 3.0-6.5 seconds). In this diagnostic study, an AI-augmented digital system significantly improved the accuracy of pathologic interpretation of colorectal polyps compared with microscopic assessment. If applied broadly to clinical practice, this tool may be associated with decreases in subsequent overuse and underuse of colonoscopy and thus with improved patient outcomes and reduced health care costs.

Artificial intelligence-assisted detection and classification of colorectal polyps under colonoscopy: a systematic review and meta-analysis.

BackgroundArtificial intelligence (AI) is used to solve the problem of missed diagnosis of polyps in colonoscopy, which has been proved to improve the detection rate of adenomas. The aim of this review was to evaluate the diagnostic performance of AI-assisted detection and classification of polyps in colonoscopy.MethodsThe literature search was undertaken on 4 electronic databases (PubMed, Web of Science, Embase, and Cochrane Library). The inclusion criteria were as follows: studies reporting AI-assisted detection and classification of polyps; studies containing patients, images, or videos receiving AI-assisted diagnosis; studies which included AI-assisted diagnosis and reported classification based on histopathology; and studies providing accurate diagnostic data. Non-English language studies, case-reports, reviews, meeting abstracts and so on were excluded. The Quality Assessment of Diagnostic Accuracy Studies-2 scale was used to evaluate the quality of literature and the Stata 13.0 software was used to perform meta-analysis.ResultsTwenty-six articles were included with all of medium quality. Meta-analysis showed none of literature had any obvious publication bias. The application of AI in detection of colorectal polyps achieved a sensitivity of 0.95 [95% confidence interval (CI): 0.89–0.98] and an area under the curve (AUC) of 0.79 (95% CI: 0.79–0.82). In the AI-assisted classification, the sensitivity was 0.92 (95% CI: 0.88–0.95) with a specificity of 0.82 (95% CI: 0.71–0.89) and an AUC of 0.94 (95% CI: 0.92–0.96). For the classification of diminutive polyps, the AI-assisted technique yielded a sensitivity of 0.95 (95% CI: 0.94–0.97), a specificity of 0.88 (95% CI: 0.74–0.95), and an AUC of 0.97 (95% CI: 0.95–0.98). For AI-assisted classification under magnifying endoscopy, the sensitivity was 0.954 (95% CI: 0.92–0.96) with a specificity of 0.95 (95% CI: 0.80–0.99) and an AUC of 0.97 (95% CI: 0.95–0.98).DiscussionThe AI-assisted technique demonstrates impressive accuracy for the detection and characterization of colorectal polyps and can be expected to be a novel auxiliary diagnosis method. Our study has inevitable limitations including heterogeneity due to different AI systems and the inability to further analyze the specificity and sensitivity of AI for different types of endoscopes.

Automated Colorectal Polyp Classification Using Deep Neural Networks with Colonoscopy Images

Automated Colorectal Polyp Classification Using Deep Neural Networks with Colonoscopy Images

Algorithm combining virtual chromoendoscopy features for colorectal polyp classification.

Background and study aims Colonoscopy is considered the gold standard for decreasing colorectal cancer incidence and mortality. Optical diagnosis of colorectal polyps (CRPs) is an ongoing challenge in clinical colonoscopy and its accuracy among endoscopists varies widely. Computer-aided diagnosis (CAD) for CRP characterization may help to improve this accuracy. In this study, we investigated the diagnostic accuracy of a novel algorithm for polyp malignancy classification by exploiting the complementary information revealed by three specific modalities. Methods We developed a CAD algorithm for CRP characterization based on high-definition, non-magnified white light (HDWL), Blue light imaging (BLI) and linked color imaging (LCI) still images from routine exams. All CRPs were collected prospectively and classified into benign or premalignant using histopathology as gold standard. Images and data were used to train the CAD algorithm using triplet network architecture. Our training dataset was validated using a threefold cross validation. Results In total 609 colonoscopy images of 203 CRPs of 154 consecutive patients were collected. A total of 174 CRPs were found to be premalignant and 29 were benign. Combining the triplet network features with all three image enhancement modalities resulted in an accuracy of 90.6 %, 89.7 % sensitivity, 96.6 % specificity, a positive predictive value of 99.4 %, and a negative predictive value of 60.9 % for CRP malignancy classification. The classification time for our CAD algorithm was approximately 90 ms per image. Conclusions Our novel approach and algorithm for CRP classification differentiates accurately between benign and premalignant polyps in non-magnified endoscopic images. This is the first algorithm combining three optical modalities (HDWL/BLI/LCI) exploiting the triplet network approach.

Real-time artificial intelligence–based histologic classification of colorectal polyps with augmented visualization

Artificial intelligence (AI)-based computer-aided diagnostic (CADx) algorithms are a promising approach for real-time histology (RTH) of colonic polyps. Our aim is to present a novel in situ CADx approach that seeks to increase transparency and interpretability of results by generating an intuitive augmented visualization of the model's predicted histology over the polyp surface. We developed a deep learning model using semantic segmentation to delineate polyp boundaries and a deep learning model to classify subregions within the segmented polyp. These subregions were classified independently and were subsequently aggregated to generate a histology map of the polyp's surface. We used 740 high-magnification narrow-band images from 607 polyps in 286 patients and over 65,000 subregions to train and validate the model. The model achieved a sensitivity of .96, specificity of .84, negative predictive value (NPV) of .91, and high-confidence rate (HCR) of .88, distinguishing 171 neoplastic polyps from 83 non-neoplastic polyps of all sizes. Among 93 neoplastic and 75 non-neoplastic polyps≤5mm, the model achieved a sensitivity of .95, specificity of .84, NPV of .91, and HCR of .86. The CADx model is capable of accurately distinguishing neoplastic from non-neoplastic polyps and provides a histology map of the spatial distribution of localized histologic predictions along the delineated polyp surface. This capability may improve interpretability and transparency of AI-based RTH and offer intuitive, accurate, and user-friendly guidance in real time for the clinical management and documentation of optical histology results.

A CNN CADx System for Multimodal Classification of Colorectal Polyps Combining WL, BLI, and LCI Modalities

Colorectal polyps are critical indicators of colorectal cancer (CRC). Blue Laser Imaging and Linked Color Imaging are two modalities that allow improved visualization of the colon. In conjunction with the Blue Laser Imaging (BLI) Adenoma Serrated International Classification (BASIC) classification, endoscopists are capable of distinguishing benign and pre-malignant polyps. Despite these advancements, this classification still prevails a high misclassification rate for pre-malignant colorectal polyps. This work proposes a computer aided diagnosis (CADx) system that exploits the additional information contained in two novel imaging modalities, enabling more informative decision-making during colonoscopy. We train and benchmark six commonly used CNN architectures and compare the results with 19 endoscopists that employed the standard clinical classification model (BASIC). The proposed CADx system for classifying colorectal polyps achieves an area under the curve (AUC) of 0.97. Furthermore, we incorporate visual explanatory information together with a probability score, jointly computed from White Light, Blue Laser Imaging, and Linked Color Imaging. Our CADx system for automatic polyp malignancy classification facilitates future advances towards patient safety and may reduce time-consuming and costly histology assessment.

Decomposition of color wavelet with higher order statistical texture and convolutional neural network features set based classification of colorectal polyps from video endoscopy

Gastrointestinal cancer is one of the leading causes of death across the world. The gastrointestinal polyps are considered as the precursors of developing this malignant cancer. In order to condense the probability of cancer, early detection and removal of colorectal polyps can be cogitated. The most used diagnostic modality for colorectal polyps is video endoscopy. But the accuracy of diagnosis mostly depends on doctors' experience that is crucial to detect polyps in many cases. Computer-aided polyp detection is promising to reduce the miss detection rate of the polyp and thus improve the accuracy of diagnosis results. The proposed method first detects polyp and non-polyp then illustrates an automatic polyp classification technique from endoscopic video through color wavelet with higher-order statistical texture feature and Convolutional Neural Network (CNN). Gray Level Run Length Matrix (GLRLM) is used for higher-order statistical texture features of different directions (Ɵ = 0o, 45o, 90o, 135o). The features are fed into a linear support vector machine (SVM) to train the classifier. The experimental result demonstrates that the proposed approach is auspicious and operative with residual network architecture, which triumphs the best performance of accuracy, sensitivity, and specificity of 98.83%, 97.87%, and 99.13% respectively for classification of colorectal polyps on standard public endoscopic video databases.

SAGES TAVAC safety and efficacy analysis confocal laser endomicroscopy.

Confocal laser endomicroscopy (CLE) is a novel endoscopic adjunct that allows real-time in vivo histological examination of mucosal surfaces. By using intravenous or topical fluorescent agents, CLE highlights certain mucosal elements that facilitate an optical biopsy in real time. CLE technology has been used in different organ systems including the gastrointestinal tract. There has been numerous studies evaluating this technology in gastrointestinal endoscopy, our aim was to evaluate the safety, value, and efficacy of this technology in the gastrointestinal tract. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Technology and Value Assessment Committee (TAVAC) performed a PubMed/Medline database search of clinical studies involving CLE in May of 2018. The literature search used combinations of the keywords: confocal laser endomicroscopy, pCLE, Cellvizio, in vivo microscopy, optical histology, advanced endoscopic imaging, and optical diagnosis. Bibliographies of key references were searched for relevant studies not covered by the PubMed search. Case reports and small case series were excluded. The manufacturer's website was also used to identify key references. The United States Food and Drug Administration (U.S. FDA) Manufacturer And User facility and Device Experience (MAUDE) database was searched for reports regarding the device malfunction or injuries. The technology offers an excellent safety profile with rare adverse events related to the use of fluorescent agents. It has been shown to increase the detection of dysplastic Barrett's esophagus, gastric intraepithelial neoplasia/early gastric cancer, and dysplasia associated with inflammatory bowel disease when compared to standard screening protocols. It also aids in the differentiation and classification of colorectal polyps, indeterminate biliary strictures, and pancreatic cystic lesions. CLE has an excellent safety profile. CLE can increase the diagnostic accuracy in a number of gastrointestinal pathologies.

Evaluation of a Deep Neural Network for Automated Classification of Colorectal Polyps on Histopathologic Slides

Histologic classification of colorectal polyps plays a critical role in screening for colorectal cancer and care of affected patients. An accurate and automated algorithm for the classification of colorectal polyps on digitized histopathologic slides could benefit practitioners and patients. To evaluate the performance and generalizability of a deep neural network for colorectal polyp classification on histopathologic slide images using a multi-institutional data set. This prognostic study used histopathologic slides collected from January 1, 2016, to June 31, 2016, from Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, with 326 slides used for training, 157 slides for an internal data set, and 25 for a validation set. For the external data set, 238 slides for 179 distinct patients were obtained from 24 institutions across 13 US states. Data analysis was performed from April 9 to November 23, 2019. Accuracy, sensitivity, and specificity of the model to classify 4 major colorectal polyp types: tubular adenoma, tubulovillous or villous adenoma, hyperplastic polyp, and sessile serrated adenoma. Performance was compared with that of local pathologists' at the point of care identified from corresponding pathology laboratories. For the internal evaluation on the 157 slides with ground truth labels from 5 pathologists, the deep neural network had a mean accuracy of 93.5% (95% CI, 89.6%-97.4%) compared with local pathologists' accuracy of 91.4% (95% CI, 87.0%-95.8%). On the external test set of 238 slides with ground truth labels from 5 pathologists, the deep neural network achieved an accuracy of 87.0% (95% CI, 82.7%-91.3%), which was comparable with local pathologists' accuracy of 86.6% (95% CI, 82.3%-90.9%). The findings suggest that this model may assist pathologists by improving the diagnostic efficiency, reproducibility, and accuracy of colorectal cancer screenings.