Artificial intelligence-based polyp size measurement in gastrointestinal endoscopy using the auxiliary waterjet as a reference

Abstract

Background and study aims Measurement of colorectal polyp size during endoscopy is mainly performed visually. In this work, we propose a novel polyp size measurement system (Poseidon) based on artificial intelligence (AI) using the auxiliary water jet as a measurement reference. Methods Visual estimation, biopsy forceps-based estimation, and Poseidon were compared using a CT-colonography-based silicone model with 28 polyps of defined sizes. Four experienced gastroenterologists estimated polyp sizes visually and with biopsy forceps. Furthermore, the gastroenterologists recorded images of each polyp with the water jet in proximity for the application of Poseidon. Additionally, Poseidon's measurements of 29 colorectal polyps during clinical routine were compared to visual estimates. Results Visual estimation had the largest median percentage error (PE) of 25.2% (95% confidence interval (CI95%): 19.1, 30.4), followed by biopsy forceps-based estimation with median 20% (14.4, 25.6) in the silicone model. Poseidon presented a significantly lower median PE of 7.4% (5, 9.4; p<0.001) than other methods. During routine colonoscopies, Poseidon presented a significantly lower median PE (7.7% 6.1, 9.3) than visual estimation (22.1% 15.1, 26.9; p<0.001). Conclusion In this work, we present a novel AI-based method for measuring colorectal polyp size with significantly higher accuracy than other common sizing methods.

Human-artificial intelligence interaction in gastrointestinal endoscopy

“…Complementarity may be enhanced by prioritising study of human interaction with novel AI platforms that can perform tasks at which human clinicians are poor e.g. measurement of polyps or other pathology, measurement/estimation of the percentage of the stomach/colon visualised during a colonoscopy[ 95 ].…”

Closing the Gap: A Critical Examination of Adherence, Inconsistency, and Improvements in Colonoscopy Reporting Practices

“…Instead, report systems could include such default values or incorporate AI-assisted reporting for most common findings. Earlier studies could already demonstrate promising results for polyp size measurement, image acquisition, and withdrawal time estimation [ 36 , 37 ].…”

New horizons in polyp size estimation

“…The year 2023 has been a remarkable year for polyp size measurement, with the emergence of new technologies that can possibly help endoscopists estimate polyp size in a more accurate way than previously. These innovative technologies include both hardware-and software-based approaches [5,6].Recently, Fujifilm Corporation provided a laser-based measurement device on the market. With the use of a special endoscope integrated with a laser function (SCALE EYE; Fujifilm Corp., Tokyo), the endoscopy processor lays a ruler over the…”

“…The year 2023 has been a remarkable year for polyp size measurement, with the emergence of new technologies that can possibly help endoscopists estimate polyp size in a more accurate way than previously. These innovative technologies include both hardware-and software-based approaches [5,6].…”