CC BY 4.0 · Endoscopy 2023; 55(12): 1118-1123
DOI: 10.1055/a-2122-1671
Innovations and brief communications

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

1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Zita Saßmannshausen
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Ioannis Kafetzis
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Philipp Sodmann
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Katja Herold
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
Boban Sudarevic
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
2   Department of Internal Medicine and Gastroenterology, Katharinenhospital, Stuttgart, Germany
,
Rüdiger Schmitz
3   Department for Interdisciplinary Endoscopy; Department of Internal Medicine I; and Department of Computational Neuroscience, University Hospital Hamburg - Eppendorf, Hamburg, Germany
,
Wolfram G. Zoller
2   Department of Internal Medicine and Gastroenterology, Katharinenhospital, Stuttgart, Germany
,
Alexander Meining
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
,
1   Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
› Author Affiliations
Baden-Württemberg StiftungFunding cluster Forum Gesundheitsstandort Baden-WürttembergEva Mayr-Stihl StiftungDieter von Holtzbrinck Stiftung GmbH, Stuttgart, GermanyFischerwerke GmbH & Co. KG, Waldachtal, GermanyGastroenterology Foundation Zurich


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.

Tables 1 s–4 s, Figs. 1 s–5 s



Publication History

Received: 28 October 2022

Accepted after revision: 30 June 2023

Accepted Manuscript online:
03 July 2023

Article published online:
23 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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