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Can artificial intelligence help to detect dysplasia in patients with ulcerative colitis?
A 72-year-old man with an 18-year history of pancolitis had been visiting our hospital regularly for 12 years. He was taking oral mesalamine and mercaptopurine to sustain clinical remission. Surveillance colonoscopy was performed using high-definition endoscopy (CF-HQ290ZI; Olympus, Tokyo, Japan) with an artificial intelligence (AI)-based detection system (EndoBRAIN-EYE; Cybernet Systems, Tokyo, Japan).
Video 1 At the moment the artificial intelligence-based detection system identified the dysplasia, it displayed the four corners of the monitor in yellow and indicated boxes bounding the dysplasia.
Histological examination of the biopsy specimens showed that both of the lesions were characterized by low-grade dysplasia ([Fig. 2 a, b]).
Patients with longstanding ulcerative colitis (UC) have a higher risk of colorectal cancer than do individuals in the general population . UC-associated dysplasia is often flat with an unclear boundary from the surrounding tissues, making it difficult to detect . AI-based polyp detection systems are used during colonoscopy to increase lesion detection . The EndoBRAIN-EYE system can reportedly identify colorectal lesions with high accuracy in non-UC patients  . However, its use for the detection of dysplasia in patients with UC has not been previously reported.
With a target biopsy strategy in UC surveillance, the ability to detect lesions depends on the endoscopist. AI has the potential to help non-expert endoscopists detect dysplasia in patients with UC.
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high
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freely accessible online.
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01 October 2020 (online)
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