TY - GEN A1 - Scheppach, Markus W. A1 - Mendel, Robert A1 - Rauber, David A1 - Probst, Andreas A1 - Nagl, Sandra A1 - Römmele, Christoph A1 - Meinikheim, Michael A1 - Palm, Christoph A1 - Messmann, Helmut A1 - Ebigbo, Alanna T1 - Artificial Intelligence (AI) improves endoscopists’ vessel detection during endoscopic submucosal dissection (ESD) T2 - Endoscopy N2 - Aims While AI has been successfully implemented in detecting and characterizing colonic polyps, its role in therapeutic endoscopy remains to be elucidated. Especially third space endoscopy procedures like ESD and peroral endoscopic myotomy (POEM) pose a technical challenge and the risk of operator-dependent complications like intraprocedural bleeding and perforation. Therefore, we aimed at developing an AI-algorithm for intraprocedural real time vessel detection during ESD and POEM. Methods A training dataset consisting of 5470 annotated still images from 59 full-length videos (47 ESD, 12 POEM) and 179681 unlabeled images was used to train a DeepLabV3+neural network with the ECMT semi-supervised learning method. Evaluation for vessel detection rate (VDR) and time (VDT) of 19 endoscopists with and without AI-support was performed using a testing dataset of 101 standardized video clips with 200 predefined blood vessels. Endoscopists were stratified into trainees and experts in third space endoscopy. Results The AI algorithm had a mean VDR of 93.5% and a median VDT of 0.32 seconds. AI support was associated with a statistically significant increase in VDR from 54.9% to 73.0% and from 59.0% to 74.1% for trainees and experts, respectively. VDT significantly decreased from 7.21 sec to 5.09 sec for trainees and from 6.10 sec to 5.38 sec for experts in the AI-support group. False positive (FP) readings occurred in 4.5% of frames. FP structures were detected significantly shorter than true positives (0.71 sec vs. 5.99 sec). Conclusions AI improved VDR and VDT of trainees and experts in third space endoscopy and may reduce performance variability during training. Further research is needed to evaluate the clinical impact of this new technology. Y1 - 2024 U6 - https://doi.org/10.1055/s-0044-1782891 VL - 56 IS - S 02 SP - S93 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Ebigbo, Alanna A1 - Mendel, Robert A1 - Scheppach, Markus W. A1 - Probst, Andreas A1 - Shahidi, Neal A1 - Prinz, Friederike A1 - Fleischmann, Carola A1 - Römmele, Christoph A1 - Gölder, Stefan Karl A1 - Braun, Georg A1 - Rauber, David A1 - Rückert, Tobias A1 - Souza Jr., Luis Antonio de A1 - Papa, João Paulo A1 - Byrne, Michael F. A1 - Palm, Christoph A1 - Messmann, Helmut T1 - Vessel and tissue recognition during third-space endoscopy using a deep learning algorithm JF - Gut N2 - In this study, we aimed to develop an artificial intelligence clinical decision support solution to mitigate operator-dependent limitations during complex endoscopic procedures such as endoscopic submucosal dissection and peroral endoscopic myotomy, for example, bleeding and perforation. A DeepLabv3-based model was trained to delineate vessels, tissue structures and instruments on endoscopic still images from such procedures. The mean cross-validated Intersection over Union and Dice Score were 63% and 76%, respectively. Applied to standardised video clips from third-space endoscopic procedures, the algorithm showed a mean vessel detection rate of 85% with a false-positive rate of 0.75/min. These performance statistics suggest a potential clinical benefit for procedure safety, time and also training. KW - Artificial Intelligence KW - Endoscopy KW - Medical Image Computing Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:898-opus4-54293 VL - 71 IS - 12 SP - 2388 EP - 2390 PB - BMJ CY - London ER -