Innovation of colonoscopy practice with use of artificial intelligence

• Project/Area Number: 19K08403
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Showa University
• Principal Investigator: Mori Yuichi 昭和大学, 医学部, 講師 (20459209)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2021: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2020: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
• Keywords: 人工知能 / 内視鏡 / 大腸癌 / 大腸ポリープ / 大腸内視鏡

Outline of Research at the Start

本研究では、「ヒトを超える人工知能」を搭載した大腸ポリープ自動診断システムを評価すべく、国際多施設共同前向き試験を実施する。
大腸の腫瘍性ポリープは前がん病変であるため、摘除が推奨されている。しかし、内視鏡での腫瘍/非腫瘍の鑑別精度は80%台に留まっており、不必要なポリープ切除が横行している。われわれは人工知能(AI)を利用することで、この問題を解決できると考え、95%超の感度・特異度で腫瘍を鑑別しうる自動診断システムを開発した（Mori, et al.Ann Intern Med 2018)。
本課題では、日欧の共同前向き試験を実施することで、有効性を今までにない高いエビデンスレベルで評価する。

Outline of Final Research Achievements

The aim of the project is to establish the value of artificial intelligence for polyp characterisation during colonoscopy. To achieve this goal, we conducted an international prospective study in collaboration with institutions in Japan, the UK, and Norway. Roughly 1300 patients were included in the study. We successfully proved that the use of AI could reduce the number of unnecessary polyp removal thanks to the increased confidence level of endoscopists who use the artificial intelligence tool during colonoscopy.

Academic Significance and Societal Importance of the Research Achievements

世界初の大規模前向き臨床研究を実施したことにより、人工知能を用いることによって医師の診断確信度が上昇し、無駄なポリープ切除が減らせることを示せた。このデータは、今後人工知能を実臨床に導入していく上で非常に参考になるものであり、行政機関が保険償還の必要性等を考える際の参照データともなりうる。

Research Products

• [Int'l Joint Research] University of Oslo(ノルウェー)
• [Int'l Joint Research] King's College(英国)
• [Int'l Joint Research] University of Oslo(ノルウェー)
• [Int'l Joint Research] King's College(英国)
• [Journal Article] Real-Time Artificial Intelligence-Based Optical Diagnosis of Neoplastic Polyps during Colonoscopy (2022)
  • Author(s): Ishita Barua, Paulina Wieszczy, Shin-ei Kudo, Michael Bretthauer, Yuichi Mori, et al.
  • Journal Title: NEJM Evidence Volume: x
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Cost-effectiveness of artificial intelligence for screening colonoscopy: a modelling study (2022)
  • Author(s): Miguel Areia, Yuichi Mori, Loredana Correale, Cesare Hassan et al.
  • Journal Title: Lancet Digital Health Volume: x
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] AI everywhere in endoscopy, not only for detection and characterization (2021)
  • Author(s): Hassan Cesare、Mori Yuichi、Antonelli Giulio
  • Journal Title: Endoscopy International Open Volume: 09 Issue: 04 Pages: E627-E628
  • DOI: 10.1055/a-1373-4799
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Charting a path forward for clinical research in artificial intelligence and gastroenterology (2021)
  • Author(s): Glissen Brown Jeremy R.、Waljee Akbar K.、Mori Yuichi、Sharma Prateek、Berzin Tyler M.
  • Journal Title: Digestive Endoscopy Volume: - Issue: 1 Pages: 4-12
  • DOI: 10.1111/den.13974
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Artificial intelligence in colonoscopy ‐ Now on the market. What's next? (2021)
  • Author(s): Mori Yuichi、Neumann Helmut、Misawa Masashi、Kudo Shin‐ei、Bretthauer Michael
  • Journal Title: Journal of Gastroenterology and Hepatology Volume: 36 Issue: 1 Pages: 7-11
  • DOI: 10.1111/jgh.15339
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Artificial Intelligence System to Determine Risk of T1 Colorectal Cancer Metastasis to Lymph Node (2021)
  • Author(s): Kudo Shin-ei、Ichimasa Katsuro、Villard Benjamin、Mori Yuichi、Misawa Masashi、et al.
  • Journal Title: Gastroenterology Volume: 160 Issue: 4 Pages: 1075-1084.e2
  • DOI: 10.1053/j.gastro.2020.09.027
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Development of a computer-aided detection system for colonoscopy and a publicly accessible large colonoscopy video database (with video) (2021)
  • Author(s): Misawa Masashi、Kudo Shin-ei、Mori Yuichi、Hotta Kinichi、Ohtsuka Kazuo、Matsuda Takahisa、Saito Shoichi、Kudo Toyoki、Baba Toshiyuki、Ishida Fumio、Itoh Hayato、Oda Masahiro、Mori Kensaku
  • Journal Title: Gastrointestinal Endoscopy Volume: 93 Issue: 4 Pages: 960-967.e3
  • DOI: 10.1016/j.gie.2020.07.060
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] How Far Will Clinical Application of AI Applications Advance for Colorectal Cancer Diagnosis? (2020)
  • Author(s): Mori Y, Kudo SE, Misawa M, Takeda K, Kudo T, Itoh H, Oda M, Mori K.
  • Journal Title: Journal of the Anus, Rectum and Colon Volume: 4 Issue: 2 Pages: 47-50
  • DOI: 10.23922/jarc.2019-045
  • NAID: 130007837269
  • ISSN: 2432-3853
  • Year and Date: 2020-04-28
  • Peer Reviewed
• [Journal Article] Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method (2020)
  • Author(s): Ahmad Omer F.、Mori Yuichi、Misawa Masashi、Kudo Shin-ei、et al.
  • Journal Title: Endoscopy Volume: - Issue: 09 Pages: 893-901
  • DOI: 10.1055/a-1306-7590
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Current status and future perspective on artificial intelligence for lower endoscopy (2020)
  • Author(s): Misawa Masashi、Kudo Shin‐ei、Mori Yuichi、Maeda Yasuharu、Ogawa Yushi、Ichimasa Katsuro、Kudo Toyoki、Wakamura Kunihiko、Hayashi Takemasa、Miyachi Hideyuki、Baba Toshiyuki、Ishida Fumio、Itoh Hayato、Oda Masahiro、Mori Kensaku
  • Journal Title: Digestive Endoscopy Volume: 33 Issue: 2 Pages: 273-284
  • DOI: 10.1111/den.13847
  • NAID: 130008066040
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Can artificial intelligence help to detect dysplasia in patients with ulcerative colitis? (2020)
  • Author(s): Maeda Yasuharu、Kudo Shin-ei、Ogata Noriyuki、Misawa Masashi、Mori Yuichi、Mori Kensaku、Ohtsuka Kazuo
  • Journal Title: Endoscopy Volume: - Issue: 07 Pages: E273-E274
  • DOI: 10.1055/a-1261-2944
  • Peer Reviewed
• [Journal Article] Robust endocytoscopic image classification based on higher-order symmetric tensor analysis and multi-scale topological statistics (2020)
  • Author(s): Itoh Hayato、Nimura Yukitaka、Mori Yuichi、Misawa Masashi、Kudo Shin-Ei、Hotta Kinichi、Ohtsuka Kazuo、Saito Shoichi、Saito Yutaka、Ikematsu Hiroaki、Hayashi Yuichiro、Oda Masahiro、Mori Kensaku
  • Journal Title: International Journal of Computer Assisted Radiology and Surgery Volume: 15 Issue: 12 Pages: 2049-2059
  • DOI: 10.1007/s11548-020-02255-3
  • NAID: 120007178396
  • Peer Reviewed
• [Journal Article] Artificial intelligence for polyp detection during colonoscopy: a systematic review and meta-analysis (2020)
  • Author(s): Barua Ishita、Vinsard Daniela Guerrero、Jodal Henriette C.、Loberg Magnus、Kalager Mette、Holme Oyvind、Misawa Masashi、Bretthauer Michael、Mori Yuichi
  • Journal Title: Endoscopy Volume: 53 Issue: 03 Pages: 277-284
  • DOI: 10.1055/a-1201-7165
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Machine learning in GI endoscopy: practical guidance in how to interpret a novel field (2020)
  • Author(s): van der Sommen Fons、de Groof Jeroen、Struyvenberg Maarten、van der Putten Joost、Boers Tim、Fockens Kiki、Schoon Erik J、Curvers Wouter、de With Peter、Mori Yuichi、Byrne Michael、Bergman Jacques J G H M
  • Journal Title: Gut Volume: 69 Issue: 11 Pages: 2035-2045
  • DOI: 10.1136/gutjnl-2019-320466
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Proceedings from the First Global Artificial Intelligence in Gastroenterology and Endoscopy Summit. (2020)
  • Author(s): Parasa S, Wallace M, Bagci U, Antonino M, Berzin T, Byrne M, Celik H, Farahani K, Golding M, Gross S, Jamali V, Mendonca P, Mori Y, Ninh A, Repici A, Rex D, Skrinak K, Thakkar SJ, van Hooft JE, Vargo J, Yu H, Xu Z, Sharma P.
  • Journal Title: Gastrointest Endosc. Volume: in press Issue: 4 Pages: 938-945.e1
  • DOI: 10.1016/j.gie.2020.04.044
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Cost savings in colonoscopy with artificial intelligence-aided polyp diagnosis: an add-on analysis of a clinical trial (with video). (2020)
  • Author(s): Mori Y, Kudo SE, East JE, Rastogi A, Bretthauer M, Misawa M, Sekiguchi M, Matsuda T, Saito Y, Ikematsu H, Hotta K, Ohtsuka K, Kudo T, Mori K.
  • Journal Title: Gastrointest Endosc. Volume: in press Issue: 4 Pages: 905-911.e1
  • DOI: 10.1016/j.gie.2020.03.3759
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Can artificial intelligence standardise colonoscopy quality? (2020)
  • Author(s): Mori Yuichi、Kudo Shin-ei、Misawa Masashi
  • Journal Title: The Lancet Gastroenterology & Hepatology Volume: 5 Issue: 4 Pages: 331-332
  • DOI: 10.1016/s2468-1253(19)30407-8
  • Peer Reviewed
• [Journal Article] Treatment policy for colonic laterally spreading tumors based on each clinicopathological feature of 4 subtypes: actual status of pseudo-depressed type. (2020)
  • Author(s): Ishigaki T, Kudo SE, Miyachi H, Hayashi T, Minegishi Y, Toyoshima N, Misawa M, Mori Y, Kudo T, Wakamura K, Baba T, Sawada N, Ishida F, Hamatani S.
  • Journal Title: Gastrointest Endosc Volume: in press Issue: 5 Pages: 1083-1094.e6
  • DOI: 10.1016/j.gie.2020.04.033
  • Peer Reviewed
• [Journal Article] Endocytoscopy with NBI has the potential to correctly diagnose diminutive colorectal polyps that are difficult to diagnose using conventional NBI. (2020)
  • Author(s): Kataoka S, Kudo SE, Misawa M, Nakamura H, Takeda K, Toyoshima N, Mori Y, Ogata N, Kudo T, Hisayuki T, Hayashi T, Wakamura K, Baba T, Ishida F.
  • Journal Title: Endosc Int Open Volume: 3 Issue: 03 Pages: E360-E367
  • DOI: 10.1055/a-1068-9228
  • Peer Reviewed
• [Journal Article] Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1. (2020)
  • Author(s): Maeda Y, Kudo SE, Ogata N, Mori Y, Misawa M, Homma M, Nemoto T, Ogawa M, Sasanuma S, Sato Y, Kataoka S, Kouyama Y, Sakurai T, Igarashi K, Ogawa Y, Kato K, Ichimasa K, Nakamura H, Kudo T, Hayashi T, Wakamura K, Baba T, Inoue H, Ohtsuka K.
  • Journal Title: Dig Endosc Volume: in press Issue: 7 Pages: 1082-1091
  • DOI: 10.1111/den.13655
  • Peer Reviewed
• [Journal Article] Endocytoscopy for the differential diagnosis of colorectal low-grade adenoma: a novel possibility for the "resect and discard" strategy. (2020)
  • Author(s): Kudo T, Suzuki K, Mori Y, Misawa M, Ichimasa K, Takeda K, Nakamura H, Maeda Y, Ogawa Y, Hayashi T, Wakamura K, Ishida F, Inoue H, Kudo SE.
  • Journal Title: Gastrointest Endosc Volume: 3 Issue: 3 Pages: 676-683
  • DOI: 10.1016/j.gie.2019.11.029
  • Peer Reviewed
• [Journal Article] Artificial Intelligence-assisted System Improves Endoscopic Identification of Colorectal Neoplasms. (2019)
  • Author(s): Kudo SE, Misawa M, Mori Y, Hotta K, Ohtsuka K, Ikematsu H, Saito Y, Takeda K, Nakamura H, Ichimasa K, Ishigaki T, Toyoshima N, Kudo T, Hayashi T, Wakamura K, Baba T, Fumio I, Inoue H, Itoh H, Oda M, Mori K.
  • Journal Title: Clin Gastroenterol Hepatol. Volume: in press Issue: 8 Pages: 1874-1881.e2
  • DOI: 10.1016/j.cgh.2019.09.009
  • Peer Reviewed
• [Journal Article] Simultaneous detection and characterization of diminutive polyps with the use of artificial intelligence during colonoscopy. (2019)
  • Author(s): Mori Y, Kudo SE, Misawa M, Mori K.
  • Journal Title: VideoGIE Volume: 4 Issue: 1 Pages: 7-10
  • DOI: 10.1016/j.vgie.2018.10.006
  • Peer Reviewed / Open Access
• [Journal Article] Stable polyp-scene classification via subsampling and residual learning from an imbalanced large dataset (2019)
  • Author(s): Itoh Hayato、Roth Holger、Oda Masahiro、Misawa Masashi、Mori Yuichi、Kudo Shin-Ei、Mori Kensaku
  • Journal Title: Healthcare Technology Letters Volume: 6 Issue: 6 Pages: 237-242
  • DOI: 10.1049/htl.2019.0079
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Correction: Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2019. (2019)
  • Author(s): Bisschops R, East JE, Hassan C, Hazewinkel Y, Kaminski MF, Neumann H, Pellis M, Antonelli G, Bustamante Balen M, Coron E, Cortas G, Iacucci M, Yuichi M, Longcroft-Wheaton G, Mouzyka S, Pilonis N, Puig I, van Hooft JE, Dekker E.
  • Journal Title: Endoscopy Volume: in press Issue: 12 Pages: C6-C6
  • DOI: 10.1055/a-1074-5788
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] The ability of positron emission tomography/computed tomography to detect synchronous colonic cancers in patients with obstructive colorectal cancer (2019)
  • Author(s): Maeda Chiyo、Endo Shungo、Mori Yuichi、Mukai Shumpei、Hidaka Eiji、Ishida Fumio、Kudo Shin-Ei
  • Journal Title: Molecular and Clinical Oncology Volume: NA
  • DOI: 10.3892/mco.2019.1815
  • Peer Reviewed
• [Journal Article] Artificial intelligence for early gastric cancer: early promise and the path ahead. (2019)
  • Author(s): Mori Y, Berzin TM, Kudo SE
  • Journal Title: Gastrointest Endosc. Volume: 89 Issue: 4 Pages: 816-817
  • DOI: 10.1016/j.gie.2018.12.019
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Artificial intelligence and colonoscopy: Current status and future perspectives (2019)
  • Author(s): Kudo Shin‐ei、Mori Yuichi、Misawa Masashi、Takeda Kenichi、Kudo Toyoki、Itoh Hayato、Oda Masahiro、Mori Kensaku
  • Journal Title: Digestive Endoscopy Volume: 31 Issue: 4 Pages: 363-371
  • DOI: 10.1111/den.13340
  • Peer Reviewed
• [Journal Article] Artificial intelligence and upper gastrointestinal endoscopy: Current status and future perspective. (2019)
  • Author(s): Mori Y, Kudo SE, Mohmed HEN, Misawa M, Ogata N, Itoh H, Oda M, Mori K
  • Journal Title: Dig Endosc. Volume: epub ahead of print Issue: 4 Pages: 378-388
  • DOI: 10.1111/den.13317
  • Peer Reviewed / Open Access / Int'l Joint Research