Colonoscopy is an effective screening procedure in colorectal cancer prevention programs;however,colonoscopy practice can vary in terms of lesion detection,classification,and removal.Artificial intelligence(AI)-assist...Colonoscopy is an effective screening procedure in colorectal cancer prevention programs;however,colonoscopy practice can vary in terms of lesion detection,classification,and removal.Artificial intelligence(AI)-assisted decision support systems for endoscopy is an area of rapid research and development.The systems promise improved detection,classification,screening,and surveillance for colorectal polyps and cancer.Several recently developed applications for AIassisted colonoscopy have shown promising results for the detection and classification of colorectal polyps and adenomas.However,their value for real-time application in clinical practice has yet to be determined owing to limitations in the design,validation,and testing of AI models under real-life clinical conditions.Despite these current limitations,ambitious attempts to expand the technology further by developing more complex systems capable of assisting and supporting the endoscopist throughout the entire colonoscopy examination,including polypectomy procedures,are at the concept stage.However,further work is required to address the barriers and challenges of AI integration into broader colonoscopy practice,to navigate the approval process from regulatory organizations and societies,and to support physicians and patients on their journey to accepting the technology by providing strong evidence of its accuracy and safety.This article takes a closer look at the current state of AI integration into the field of colonoscopy and offers suggestions for future research.展开更多
BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the sub...BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.展开更多
文摘Colonoscopy is an effective screening procedure in colorectal cancer prevention programs;however,colonoscopy practice can vary in terms of lesion detection,classification,and removal.Artificial intelligence(AI)-assisted decision support systems for endoscopy is an area of rapid research and development.The systems promise improved detection,classification,screening,and surveillance for colorectal polyps and cancer.Several recently developed applications for AIassisted colonoscopy have shown promising results for the detection and classification of colorectal polyps and adenomas.However,their value for real-time application in clinical practice has yet to be determined owing to limitations in the design,validation,and testing of AI models under real-life clinical conditions.Despite these current limitations,ambitious attempts to expand the technology further by developing more complex systems capable of assisting and supporting the endoscopist throughout the entire colonoscopy examination,including polypectomy procedures,are at the concept stage.However,further work is required to address the barriers and challenges of AI integration into broader colonoscopy practice,to navigate the approval process from regulatory organizations and societies,and to support physicians and patients on their journey to accepting the technology by providing strong evidence of its accuracy and safety.This article takes a closer look at the current state of AI integration into the field of colonoscopy and offers suggestions for future research.
文摘BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.
