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AI Reliably Identifies Diminutive Polyps During Colonoscopy

By MedImaging International staff writers
Posted on 10 Sep 2018

Image: A new study claims computer-aided diagnosis can help identify cancerous polyps (Photo courtesy of Yuichi Mori/ SUHY).

Real-time computer-aided diagnosis (CAD) may help endoscopists distinguish between small neoplastic and benign polyps during colonoscopy, claims a new study.

Researchers at Nagoya University (Japan), Showa University Northern Yokohama Hospital (SUHY; Japan), and other institutions conducted an open-label, prospective study in 791 consecutive patients undergoing colonoscopy at SUHY in order to evaluate the performance of real-time artificial intelligence (AI)-driven CAD in analyzing microvascular and cellular images obtained using a X520 ultra-magnifying endocytoscope, following application of narrow-band imaging (NBI) and methylene blue staining modes.

The CAD-predicted pathology of detected diminutive polyps--less than five mm in diameter--was then compared to pathologic diagnosis of the resected specimen (gold standard). The primary end point was whether CAD with the stained mode produced a negative predictive value (NPV) of 90% or greater for identifying diminutive rectosigmoid adenomas, the standard threshold required to “diagnose-and-leave” nonneoplastic polyps. Best- and worst-case scenarios assumed that polyps lacking either CAD diagnosis or pathology were true- or false-positive or true- or false-negative, respectively.

The results revealed that of the 466 diminutive polyps (250 of them rectosigmoid adenomas) resected from 325 patients assessed by CAD, pathologic prediction rate was 98.1%. The diminutive rectosigmoid adenoma negative predictive value of CAD--with stained mode--was 96.4% in the best-case scenario, and 93.7% in the worst-case scenario. With NBI, the best-case scenario was 96.5% and the worst-case scenario was 95.2%. The study was published on August 14, 2018, in Annals of Internal Medicine.

“The most remarkable breakthrough with this system is that AI enables real-time optical biopsy of colorectal polyps during colonoscopy, regardless of the endoscopists’ skill. This allows the complete resection of adenomatous polyps, and prevents unnecessary polypectomy of non-neoplastic polyps,” said lead author Yuichi Mori, MD, PhD, of the SUHY Digestive Disease Center. “We believe these results are acceptable for clinical application and our immediate goal is to obtain regulatory approval for the diagnostic system.”

Benign colorectal adenomas develop from epithelial tissue, while most colorectal cancer develops from adenomatous polyps, and are in turn termed adenocarcinomas. Colonoscopy screening helps identify and remove adenomas before they become a problem, since the bigger the adenoma, the greater its chances of being cancerous. For example, an adenoma, which is 15 mm in diameter, has a 30-50% chance to turn cancerous.

Related Links:
Nagoya University
Showa University Northern Yokohama Hospital

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68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294774799 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294774799 AND published='1' LIMIT 1

69 (35.04753112793): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (236.98806762695): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (210.04676818848): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (36.954879760742): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (99.897384643555): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (28.848648071289): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (32.901763916016): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (55.789947509766): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (97.036361694336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.232833862305): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

105 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

106 (58.174133300781): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (51.021575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

109 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

110 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (478.98292541504): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (714.06364440918): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (360.96572875977): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (283.95652770996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

115 (458.95576477051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

116 (375.98609924316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

117 (213.1462097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

118 (298.02322387695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

119 (218.86825561523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

120 (298.97689819336): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 35951.852798462): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (126.83868408203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

123 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

124 (427.9613494873): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774799 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774799 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 627170.08590698): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (111.10305786133): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (506.16264343262): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (171.89979553223): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (422.00088500977): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (303.03001403809): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (53.167343139648): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (607.01370239258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (629.18663024902): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (290.1554107666): SELECT name FROM jos_deeppockets WHERE id=215

136 (38.14697265625): SELECT name FROM jos_deeppockets WHERE id=215

137 (449.89585876465): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (399.11270141602): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

140 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

141 (!!!!! 9391.0694122314): TRUNCATE TABLE jos_trademed_module

142 (117.77877807617): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774799 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (859.97581481934): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

147 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

148 (!!!!! 1157.0453643799): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

150 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

151 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774799 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774799 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (34.809112548828): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (33.140182495117): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (99.18212890625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

156 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774799 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774799 AND published='1' LIMIT 1

157 (!!!!! 6973.9818572998): select jos_twitters.link from jos_twitters where cat=10

158 (159.02519226074): select jos_facebook.link from jos_facebook where cat=10

159 (51.975250244141): select jos_google_plus.link from jos_google_plus where cat=10

160 (51.975250244141): select jos_linkedin.link from jos_linkedin where cat=10

161 (437.02125549316): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1627.9220581055): insert into jos_banners_delta values (14615,'2025-06-18 01:21:28','216.73.216.120','view'),(14202,'2025-06-18 01:21:28','216.73.216.120','view'),(14203,'2025-06-18 01:21:28','216.73.216.120','view')

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