Reduction of death from colorectal cancer with help of artificial intelligence

• Project/Area Number: 19KK0421
• Research Category: Fund for the Promotion of Joint International Research (Fostering Joint International Research (A))
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Showa University
• Principal Investigator: Mori Yuichi 昭和大学, 医学部, 兼任講師 (20459209)
• Project Period (FY): 2019 – 2022
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥15,210,000 (Direct Cost: ¥11,700,000、Indirect Cost: ¥3,510,000)
• Keywords: 人工知能 / 内視鏡 / 大腸癌 / 大腸ポリープ

Outline of Research at the Start

本国際研究では、人工知能(AI)を利用した大腸内視鏡検査により、「命を救える」ことを証明する。申請者ら（森悠一・工藤進英・三澤将史）は、4期にわたる科研費支援および名大（森健策教授）との医工連携研究により大腸内視鏡診断支援システムを開発したが、これにより、将来の癌死が抑制できるか立証するのは本邦では困難だった。
本研究では、内視鏡疫学研究の先駆者であるオスロ大学の協力の下、ノルウェー独自の「死亡データが自動リンクする公的検診レジストリー」を研究利用することで、超低コストの大規模ランダム化試験を実施する。AIによる死亡率抑制効果をプライマリーエンドポイントとし、内視鏡AIの真の有効性を検証する。

Outline of Final Research Achievements

Artificial intelligence (AI) for colonoscopy is expected to automatically detect colorectal polyps during colonoscopy and prevent doctors from overlooking them. The aim of this study project is to verify/infer whether future cancer deaths can actually be reduced by the use of AI. In order to achieve this objective, microsimulation studies and meta-analyses were conducted on the effect of AI on cancer incidence and mortality. Results of these studies were used to develop a randomised controlled trial design sufficient to verify the effectiveness of AI. These have enabled the establishment of a research infrastructure that will form the basis for large-scale clinical trials.

Academic Significance and Societal Importance of the Research Achievements

人工知能（AI)の臨床応用においては、その有用性について十分な証拠が欠如している。本研究は、AIを大腸内視鏡に併用することで、将来の大腸がん罹患率を約５パーセント減らすことができることを高精度のシミュレーション研究で示した点において、学術的意義がある。今後は、実際の患者様への導入をすることでリアルワールドの有効性を検証する必要があるため、その意味で、研究インフラを確立させた本研究の社会的意義は大きい。

Research Products

• [Int'l Joint Research] University of Oslo(ノルウェー) (2020)
  • Year and Date: 2020-04-01
• [Journal Article] Open access database for artificial intelligence research (2023)
  • Author(s): Halvorsen Natalie、Mori Yuichi
  • Journal Title: Gastrointestinal Endoscopy Volume: 97 Issue: 2 Pages: 200-201
  • DOI: 10.1016/j.gie.2022.10.020
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Impact of Artificial Intelligence on Colonoscopy Surveillance After Polyp Removal: A Pooled Analysis of Randomized Trials (2023)
  • Author(s): Mori Yuichi、Wang Pu、Loberg Magnus、Misawa Masashi、et al.
  • Journal Title: Clinical Gastroenterology and Hepatology Volume: 21 Issue: 4 Pages: 949-959.e2
  • DOI: 10.1016/j.cgh.2022.08.022
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Cost-effectiveness of artificial intelligence for screening colonoscopy: a modelling study (2022)
  • Author(s): Areia Miguel、Mori Yuichi、Correale Loredana、Repici Alessandro、Bretthauer Michael、Sharma Prateek、Taveira Filipe、Spadaccini Marco、Antonelli Giulio、Ebigbo Alanna、Kudo Shin-ei、Arribas Julia、Barua Ishita、Kaminski Michal F、Messmann Helmut、Rex Douglas K、Dinis-Ribeiro M?rio、Hassan Cesare
  • Journal Title: The Lancet Digital Health Volume: 4 Issue: 6 Pages: e436-e444
  • DOI: 10.1016/s2589-7500(22)00042-5
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] High-quality Studies of Artificial Intelligence in Colonoscopy Illuminate a Next Important Step (2022)
  • Author(s): Ahuja Amisha、Mori Yuichi
  • Journal Title: Gastroenterology Volume: 163 Issue: 3 Pages: 582-583
  • DOI: 10.1053/j.gastro.2022.06.074
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] How to Integrate Artificial Intelligence in Gastrointestinal Practice (2022)
  • Author(s): Messmann Helmut、Ebigbo Alanna、Hassan Cesare、Repici Alessandro、Mori Yuichi
  • Journal Title: Gastroenterology Volume: 162 Issue: 6 Pages: 1583-1586
  • DOI: 10.1053/j.gastro.2022.02.029
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Clinical trial designs for artificial intelligence in gastrointestinal endoscopy (2022)
  • Author(s): Mori Yuichi、Kaminski Michal F、Hassan Cesare、Bretthauer Michael
  • Journal Title: The Lancet Gastroenterology & Hepatology Volume: 7 Issue: 9 Pages: 785-786
  • DOI: 10.1016/s2468-1253(22)00232-1
  • 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 (co-first author), Loredana Correale, et al.
  • Journal Title: Lancet Digital Health Volume: x
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Real-Time Artificial Intelligence-based Optical Diagnosis of Neoplastic Polyps during Colonoscopy (2022)
  • Author(s): Ishita Barua, Paulina Wieszcy, Shin-ei Kudo, Yuichi Mori (last author) et al.
  • Journal Title: NEJM Evidence Volume: x
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Reply (2021)
  • Author(s): Kudo Shin-ei、Ichimasa Katsuro、Mori Yuichi
  • Journal Title: Gastroenterology Volume: 161 Issue: 2 Pages: 733-734
  • DOI: 10.1053/j.gastro.2021.04.065
  • Peer Reviewed
• [Journal Article] Commentary (2021)
  • Author(s): Mori Yuichi
  • Journal Title: Endoscopy Volume: 53 Issue: 12 Pages: 1287-1287
  • DOI: 10.1055/a-1561-6046
• [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] Challenge to the “impossible” (2021)
  • Author(s): Kudo Shin-ei、Misawa Masashi、Mori Yuichi
  • Journal Title: Gastrointestinal Endoscopy Volume: 94 Issue: 3 Pages: 639-640
  • DOI: 10.1016/j.gie.2021.05.029
• [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] Addressing false-positive findings with artificial intelligence for polyp detection (2021)
  • Author(s): Mori Yuichi、Bretthauer Michael
  • Journal Title: Endoscopy Volume: 53 Issue: 09 Pages: 941-942
  • DOI: 10.1055/a-1381-7849
  • Int'l Joint Research
• [Journal Article] Binary polyp-size classification based on deep-learned spatial information (2021)
  • Author(s): Itoh Hayato、Oda Masahiro、Jiang Kai、Mori Yuichi、Misawa Masashi、Kudo Shin-Ei、Imai Kenichiro、Ito Sayo、Hotta Kinichi、Mori Kensaku
  • Journal Title: International Journal of Computer Assisted Radiology and Surgery Volume: 16 Issue: 10 Pages: 1817-1828
  • DOI: 10.1007/s11548-021-02477-z
  • NAID: 120007178395
  • Peer Reviewed
• [Journal Article] Hopes and Hypes for Artificial Intelligence in Colorectal Cancer Screening (2021)
  • Author(s): Mori Yuichi、Bretthauer Michael、Kalager Mette
  • Journal Title: Gastroenterology Volume: 161 Issue: 3 Pages: 774-777
  • DOI: 10.1053/j.gastro.2021.04.078
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Artificial intelligence-assisted colonic endocytoscopy for cancer recognition: a multicenter study (2021)
  • Author(s): Mori Yuichi、Kudo Shin-ei、Misawa Masashi、Hotta Kinichi、Kazuo Ohtsuka、Saito Shoichi、Ikematsu Hiroaki、Saito Yutaka、Matsuda Takahisa、Kenichi Takeda、Kudo Toyoki、Nemoto Tetsuo、Itoh Hayato、Mori Kensaku
  • Journal Title: Endoscopy International Open Volume: 09 Issue: 07 Pages: E1004-E1011
  • DOI: 10.1055/a-1475-3624
  • Peer Reviewed
• [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] 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] 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