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CC BY 4.0 · Endoscopy 2025; 57(S 01): E557-E559
DOI: 10.1055/a-2598-4576
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Endoscopic virtual ruler based on artificial intelligence technology

Yaxian Kuai
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Zhihong Wang
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Xuecan Mei
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Zhuang Zeng
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Yuchuan Bai
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
,
Aijiu Wu
2   Research and Development Department, Hefei Zhongna Medical Instrument Co. Ltd., Hefei, China
,
Derun Kong 
1   Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, China (Ringgold ID: RIN36639)
› Institutsangaben

Gefördert durch: 2022 Key Research and Development Plan Project of the Science and Technology Department of Anhui Province 2022e07020048 Clinical Trial: Registration number (trial ID): ChiCTR2200064028, Trial registry: Chinese Clinical Trial Registry, Type of Study:
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Measurement and evaluation of lesion size has always been one of the difficult problems to solve in endoscopy [1]. Recently, we developed a real-time endoscopic virtual ruler measurement technology based on artificial intelligence (AI) technology.

Geometric optics showed that the distance of the object was the only variable affecting the ratio of the size of the object to the size of the image when the focal length was fixed and the lesion was centered (the transverse distance from the main optical axis was zero) [2]. Therefore, to obtain the actual size of the lesion, it is only necessary to measure the distance from the end of the lens to the lesion (object distance) and calculate the ratio of the size of the object to that of the image ([Fig. 1]). This detection method can now be implemented using the image recognition technology of computer vision.

Zoom
Fig. 1 Schematic diagram of the endoscopic virtual ruler. The radius of the endoscope is R, the height of the transparent cap above the endoscopy is H 1, the diameter of the measured object is L, and the increased distance between the tip of the endoscope and the measured object is H 2 (this distance can be obtained from the scale on the endoscope), L=R+H 1×(H−H 1)/R.

To do this, first install the transparent cap at the front end of the endoscope (10 mm/13 mm internal diameter) and adjust the distance of the cap end to the lesion until the lesion is fully within the field of view of the transparent endoscope cap, as the size of the inner diameter of the transparent cap is known. At this point, simply enter the distance from the front end of the endoscope to the maximum diameter of the lesion in the measurement system (recorded by an endoscope scale), and the measurement system will analyze the image of the target, forming a ruler that can measure the size of the lesion ([Fig. 2]).

Zoom
Fig. 2 Schematic diagram of the operation process of the endoscopic virtual ruler.

Various clinical cases were studied ([Video 1]) after comparing the scale of the virtual ruler with that of the physical ruler at different distances in vitro ([Fig. 3]). The size of polyps and early cancer lesions could be well evaluated by using the model. Doctors can use virtual ruler measurement technology to measure lesions effectively during endoscopy.

The endoscopic virtual ruler is introduced and its clinical application shown for various types of lesions and at different distances.Video 1

Zoom
Fig. 3 Comparison of the scale of the virtual ruler and that of the physical ruler at different distances.

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Conflict of Interest

The authors declare that they have no conflict of interest.

  • References

  • 1 Shimoda R, Akutagawa T, Tomonaga M. et al. Estimating colorectal polyp size with a virtual scale endoscope and visual estimation during colonoscopy: prospective, preliminary comparison of accuracy. Digest Endosc 2022; 34: 1471-1477
    CrossrefPubMedSuche in Google Scholar
  • 2 Jin J, Dong B, Ye C. et al. A noninvasive technology using artificial intelligence to measure the diameter of esophageal varices under endoscopy. Surg Laparosc Endosc Percutan Tech 2023; 33: 282
    CrossrefPubMedSuche in Google Scholar

Correspondence

Derun Kong, MD
Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University
No. 81 Jixi Road
Shushan District, Hefei City, 230031 Anhui Province
China   

Publikationsverlauf

Artikel online veröffentlicht:
13. Juni 2025

© 2025. 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/).

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  • References

  • 1 Shimoda R, Akutagawa T, Tomonaga M. et al. Estimating colorectal polyp size with a virtual scale endoscope and visual estimation during colonoscopy: prospective, preliminary comparison of accuracy. Digest Endosc 2022; 34: 1471-1477
    CrossrefPubMedSuche in Google Scholar
  • 2 Jin J, Dong B, Ye C. et al. A noninvasive technology using artificial intelligence to measure the diameter of esophageal varices under endoscopy. Surg Laparosc Endosc Percutan Tech 2023; 33: 282
    CrossrefPubMedSuche in Google Scholar

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Zoom
Fig. 1 Schematic diagram of the endoscopic virtual ruler. The radius of the endoscope is R, the height of the transparent cap above the endoscopy is H 1, the diameter of the measured object is L, and the increased distance between the tip of the endoscope and the measured object is H 2 (this distance can be obtained from the scale on the endoscope), L=R+H 1×(H−H 1)/R.
Zoom
Fig. 2 Schematic diagram of the operation process of the endoscopic virtual ruler.
Zoom
Fig. 3 Comparison of the scale of the virtual ruler and that of the physical ruler at different distances.