scholarly journals Predictive rules for optical diagnosis of < 10-mm colorectal polyps based on a dedicated software

Endoscopy ◽  
2019 ◽  
Vol 52 (01) ◽  
pp. 52-60 ◽  
Author(s):  
Cesare Hassan ◽  
Raf Bisschops ◽  
Pradeep Bhandari ◽  
Emmanuel Coron ◽  
Helmut Neumann ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Colorectal Polyp ◽  
Colorectal Polyps ◽  
Hyperplastic Polyps ◽  
High Confidence ◽  
Still Images ◽  
The Individual ◽  
Video Library ◽  
Leave One Out

Abstract Background The BASIC classification for predicting in vivo colorectal polyp histology incorporates both surface and pit/vessel descriptor domains. This study aimed to define new BASIC classes for adenomatous and hyperplastic polyps. Methods A video library (102 still images/videos of < 10-mm polyps using white-light [WLI] and blue-light imaging [BLI]) was reviewed by seven expert endoscopists. Polyps were rated according to the individual descriptors of the three BASIC domains (surface/pit/vessel). A model to predict polyp histology (adenomatous or hyperplastic) was developed using multivariable logistic regression and subsequent “leave-one-out” cross-validation. New BASIC rules were then defined by Delphi agreement. The overall accuracy of these rules when used by experts was evaluated according to the level of confidence and light type. Results The strength of prediction for adenomatous histology from 2175 observations assessed by area under the curve (AUC; 95 % confidence interval) was poor-to-fair for the surface descriptors (0.50 [0.33 – 0.69] for mucus; 0.68 [0.57 – 0.79] for irregular surface), but stronger for pits (0.87 [0.80 – 0.96] for featureless/round/not round) and vessels (0.80 [0.65 – 0.87] for not present/lacy/pericryptal). By combining the domains, a good-to-excellent prediction was shown (AUC 0.89 [0.81 – 0.96]). After the definition of new BASIC rules for adenomatous and hyperplastic polyps, accuracy for high confidence BLI predictions was 90.3 % (86.3 % – 93.2 %), which was superior to high confidence WLI (83.7 % [77.3 % – 87.7 %]) and low confidence BLI predictions (77.7 % [61.1 % – 88.6 %]). Conclusions Based on the strength of prediction, the new BASIC classes for adenomatous and hyperplastic histology show favorable results for accuracy and confidence levels.

BASIC (BLI Adenoma Serrated International Classification) classification for colorectal polyp characterization with blue light imaging

Endoscopy ◽  
2017 ◽  
Vol 50 (03) ◽  
pp. 211-220 ◽  
Author(s):  
Raf Bisschops ◽  
Cesare Hassan ◽  
Pradeep Bhandari ◽  
Emmanuel Coron ◽  
Helmut Neumann ◽  
...  
Keyword(s):  
Blue Light ◽  
Interobserver Agreement ◽  
Colorectal Polyp ◽  
High Definition ◽  
Still Images ◽  
Heterogeneous Distribution ◽  
Modified Delphi ◽  
Optical Magnification ◽  
High Concordance ◽  
Video Library

Abstract Background and study aim Advanced endoscopic imaging has revolutionized the characterization of lesions during colonoscopy. The aim of this study was to create a new classification for differentiating subcentimetric hyperplastic and adenomatous polyps, and deeply invasive malignant lesions using blue-light imaging (BLI) with high definition, with and without optical magnification, as well as to assess its interobserver concordance. Methods A video library consisting of 48 videos/still images (with/without optical magnification) from 24 histologically verified polyps/cancer with BLI was prospectively created. In the first step, seven endoscopists with experience in electronic chromoendoscopy reviewed 12 BLI videos/still images with/without magnification representative of the different histotypes, and individually identified possible descriptors. In the second step, these descriptors were categorized and summarized with a modified Delphi methodology. In the third step, the seven endoscopists independently reviewed the remaining 36 videos/still images with/without optical magnification, and the interobserver agreement for the new descriptors was assessed. The interobserver agreement between endoscopists was assessed using Gwet’s AC1. Results By reviewing the initial 12 videos/still images, 43 descriptors were proposed. By a modified Delphi process, the endoscopists eventually agreed on summarizing 12 descriptors into three main domains. The main domains identified were: polyp surface (mucus, yes/no; regular/irregular; [pseudo]depressed, yes/no), pit appearance (featureless, yes/no; round/nonround with/without dark spots; homogeneous/heterogeneous distribution with/without focal loss), and vessels (present/absent, lacy, pericryptal, irregular). Interobserver agreement for the polyp surface domain appeared to be almost perfect for mucus (AC1 0.92 with and 0.88 without optical magnification), substantial for the regular/irregular surface (AC1 0.67 with and 0.66 without optical magnification). For the pit appearance domain, interobserver agreement was good for featureless (AC1 0.9 with and 0.8 without optical magnification), and round/nonround (AC1 0.77 with and 0.69 without optical magnification) descriptors, but less consistent for the homogeneity of distribution (AC1 with/without optical magnification 0.58). Agreement was almost perfect for the vessel domain (AC1 0.81 – 0.85). Conclusions The new BASIC classification takes into account both morphological features of the polyp, as well as crypt and vessel characteristics. A high concordance among the observers was shown for most of the summarized descriptors. Optical magnification had a beneficial effect in terms of interobserver agreement for most of the descriptors.

scholarly journals Automated endoscopic detection and classification of colorectal polyps using convolutional neural networks

2020 ◽  
Vol 13 ◽  
pp. 175628482091065 ◽  
Author(s):  
Tsuyoshi Ozawa ◽  
Soichiro Ishihara ◽  
Mitsuhiro Fujishiro ◽  
Youichi Kumagai ◽  
Satoki Shichijo ◽  
...  
Keyword(s):  
White Light ◽  
Colorectal Polyps ◽  
Future Application ◽  
Single Shot ◽  
Still Images ◽  
Promising Application ◽  
American Society ◽  
Measure Of Performance

Background: Recently the American Society for Gastrointestinal Endoscopy addressed the ‘resect and discard’ strategy, determining that accurate in vivo differentiation of colorectal polyps (CP) is necessary. Previous studies have suggested a promising application of artificial intelligence (AI), using deep learning in object recognition. Therefore, we aimed to construct an AI system that can accurately detect and classify CP using stored still images during colonoscopy. Methods: We used a deep convolutional neural network (CNN) architecture called Single Shot MultiBox Detector. We trained the CNN using 16,418 images from 4752 CPs and 4013 images of normal colorectums, and subsequently validated the performance of the trained CNN in 7077 colonoscopy images, including 1172 CP images from 309 various types of CP. Diagnostic speed and yields for the detection and classification of CP were evaluated as a measure of performance of the trained CNN. Results: The processing time of the CNN was 20 ms per frame. The trained CNN detected 1246 CP with a sensitivity of 92% and a positive predictive value (PPV) of 86%. The sensitivity and PPV were 90% and 83%, respectively, for the white light images, and 97% and 98% for the narrow band images. Among the correctly detected polyps, 83% of the CP were accurately classified through images. Furthermore, 97% of adenomas were precisely identified under the white light imaging. Conclusions: Our CNN showed promise in being able to detect and classify CP through endoscopic images, highlighting its high potential for future application as an AI-based CP diagnosis support system for colonoscopy.

scholarly journals Circulating lncRNA DANCR as a potential auxillary biomarker for the diagnosis and prognostic prediction of colorectal cancer

2020 ◽  
Vol 40 (3) ◽  
Author(s):  
Xianjuan Shen ◽  
Yajing Xue ◽  
Hui Cong ◽  
Xudong Wang ◽  
Zhiwei Fan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Expression Profiles ◽  
Simultaneous Detection ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Colorectal Polyp ◽  
Colorectal Polyps ◽  
Diagnostic Efficiency ◽  
Potential Biomarker ◽  
Pre Treatment

Abstract Studies have shown that long non-coding RNAs (lncRNAs) play vital roles in the development of cancer, including colorectal cancer (CRC). Our purpose is to validate the diagnostic value of serum differentiation antagonizing non-protein coding RNA (DANCR) in CRC by focusing on its expression and clinical application. lncRNA expression profiles of CRC patients were obtained and analyzed by repurposing the publically available microarray data. Tissue or serum specimens were obtained from 40 patients with primary CRC, 10 patients with recurrent CRC, 40 patients with colorectal polyps, and 40 healthy controls. It was found that DANCR level in the CRC tissue and serum was significantly increased, and serum DANCR expression was decreased in post-operative patients as compared with that in pre-treatment patients and recurrent patients. In addition, serum DANCR expression was significantly correlated with different TNM stages. Correlation analysis of DANCR and other diagnostic indicators showed that the serum DANCR expression level was significantly correlated with CA199 but not with CEA in CRC patients. As for diagnostic efficiency by ROC analysis, the area under the curve (AUC) of serum DANCR was higher than that of CEA and CA199 in CRC group vs. colorectal polyp group. Simultaneous detection of DANCR, CEA and CA199 yielded the highest sensitivity and AUC as compared with either of them alone. Taken together, serum DANCR was up-regulated in CRC patients and high expression of DANCR may prove to be a potential biomarker for the diagnosis of CRC.

scholarly journals Post-polypectomy surveillance interval based on flexible spectral color imaging enhancement (FICE) with magnifying zoom imaging for optical biopsy

2018 ◽  
Vol 06 (08) ◽  
pp. E1051-E1058
Author(s):  
Rodrigo de Rezende Zago ◽  
Pedro Popoutchi ◽  
Lucas Santana Nova da Costa ◽  
Marcelo Averbach
Keyword(s):  
Task Force ◽  
Colorectal Polyps ◽  
Optical Biopsy ◽  
Intraobserver Agreement ◽  
High Confidence ◽  
Color Imaging ◽  
Neoplastic Lesions ◽  
Surveillance Interval ◽  
Pathological Assessment

Abstract Background and study aims Post-polypectomy surveillance interval (SI) is determined based on the number, size, and histology of colorectal polyps. Electronic chromoendoscopy in association with magnifying imaging colonoscopy allows “in vivo” polyp histology prediction. Colorectal polyps ≤ 5 mm can be resected and discarded without pathologic assessment if the endoscopic technology when used with high confidence provides ≥ 90 % agreement between the post-polypectomy SI and the SI based on pathological assessment. The aim of this study was to evaluate the agreement between the post-polypectomy SI based on flexible spectral color imaging enhancement (FICE) chromoendoscopy in association with magnified imaging and the pathology-based SI. Patients and methods Each diagnosed colorectal polyp received a histology prediction (neoplastic or non-neoplastic) based on the FICE capillary-vessel pattern classification. Each prediction was classified as high or low confidence. SI based on the FICE prediction was compared to the pathology-based SI recommendation according to the US Multi-Society Task Force on Colorectal Cancer guideline. Sensitivity, specificity and accuracy of FICE in diagnosing neoplastic lesions were compared with the pathology assessment. Interobserver and intraobserver agreement for FICE-based SI predictions was evaluated using the kappa coefficient. Results A total of 267 polyps had histology prediction assessed with high confidence in 136 patients. Sensitivity of FICE was 98.7 % (95 % CI: 93.5 – 99.3) and specificity was 62.5 % (95 % CI: 43.6 – 78.9). Prediction accuracy was 94.4 % (95 % CI: 88.6 – 96 – 1) in differentiating between neoplastic and non-neoplastic lesions. Therefore, magnifying FICE colonoscopy-based SI recommendation was consistent with pathological assessment in 88.3 % of general cases (95 % CI: 82.1 – 92.6) and in 89.7 % (95 % CI: 83 – 94.5) of the high-confidence evaluation cases. The intraobserver agreement value for FICE-based SI predictions was 0.87 (high-confidence evaluations), and the interobserver agreement values were 0.78 (high- and low-confidence evaluations) and 0.82 (high-confidence evaluations) (95 % CI: 0.79 – 0.95). Conclusions FICE-based SI demonstrated 89.7 % concordance with the pathology-based SI.

scholarly journals Algorithm combining virtual chromoendoscopy features for colorectal polyp classification

2021 ◽  
Vol 09 (10) ◽  
pp. E1497-E1503
Author(s):  
Ramon-Michel Schreuder ◽  
Qurine E.W. van der Zander ◽  
Roger Fonollà ◽  
Lennard P.L. Gilissen ◽  
Arnold Stronkhorst ◽  
...  
Keyword(s):  
Predictive Value ◽  
Gold Standard ◽  
Network Architecture ◽  
Colorectal Polyp ◽  
Colorectal Polyps ◽  
Training Dataset ◽  
High Definition ◽  
Still Images ◽  
Novel Approach ◽  
Incidence And Mortality

Abstract Background and study aims Colonoscopy is considered the gold standard for decreasing colorectal cancer incidence and mortality. Optical diagnosis of colorectal polyps (CRPs) is an ongoing challenge in clinical colonoscopy and its accuracy among endoscopists varies widely. Computer-aided diagnosis (CAD) for CRP characterization may help to improve this accuracy. In this study, we investigated the diagnostic accuracy of a novel algorithm for polyp malignancy classification by exploiting the complementary information revealed by three specific modalities. Methods We developed a CAD algorithm for CRP characterization based on high-definition, non-magnified white light (HDWL), Blue light imaging (BLI) and linked color imaging (LCI) still images from routine exams. All CRPs were collected prospectively and classified into benign or premalignant using histopathology as gold standard. Images and data were used to train the CAD algorithm using triplet network architecture. Our training dataset was validated using a threefold cross validation. Results In total 609 colonoscopy images of 203 CRPs of 154 consecutive patients were collected. A total of 174 CRPs were found to be premalignant and 29 were benign. Combining the triplet network features with all three image enhancement modalities resulted in an accuracy of 90.6 %, 89.7 % sensitivity, 96.6 % specificity, a positive predictive value of 99.4 %, and a negative predictive value of 60.9 % for CRP malignancy classification. The classification time for our CAD algorithm was approximately 90 ms per image. Conclusions Our novel approach and algorithm for CRP classification differentiates accurately between benign and premalignant polyps in non-magnified endoscopic images. This is the first algorithm combining three optical modalities (HDWL/BLI/LCI) exploiting the triplet network approach.

Design, Synthesis, Anticonvulsant Activity, Preclinical Study and Pharmacokinetic Performance of N-{[3-(4-chlorophenyl)-4-oxo-3, 4-dihydroquinazolin- 2-yl] methyl}, 2-[(2-isopropyl-5-methyl) 1-cyclo Hexylidene] Hydrazinecarboxamide

2019 ◽  
Vol 19 (1) ◽  
pp. 31-45
Author(s):  
Meena K. Yadav ◽  
Laxmi Tripathi
Keyword(s):  
Anticonvulsant Activity ◽  
Computational Study ◽  
Plasma Concentrations ◽  
Elimination Rate ◽  
Area Under The Curve ◽  
Preclinical Study ◽  
In Vivo Studies ◽  
Maximum Plasma ◽  
Seizure Models

Background: N-{[3-(4-chlorophenyl)-4-oxo-3, 4-dihydroquinazolin-2-yl] methyl}, 2-[(2- isopropyl-5-methyl) 1-cyclohexylidene] hydrazinecarboxamide QS11 was designed by computational study. It possessed essential pharmacophoric features for anticonvulsant activity and showed good docking with iGluRs (Kainate) glutamate receptor. Methods: QSAR and ADMET screening results suggested that QS11 would possess good potency for anticonvulsant activity. QS11 was synthesised and evaluated for its anticonvulsant activity and neurotoxicity. QS11 showed protection in strychnine, thiosemicarbazide, 4-aminopyridine and scPTZ induced seizure models and MES seizure model. QS11 showed higher ED50, TD50 and PI values as compared to the standard drugs in both MES and scPTZ screen. A high safety profile (HD50/ED50 values) was noted and hypnosis, analgesia, and anaesthesia were only observed at higher doses. No considerable increase or decrease in the concentration of liver enzymes was observed. Optimized QS11 was subjected to preclinical (in-vivo) studies and the pharmacokinetic performance of the sample was investigated. The result revealed that the pharmacokinetic performance of QS11 achieved maximum plasma concentrations (Cmax) of 0.315 ± 0.011 µg/mL at Tmax of 2.0 ± 0.13 h, area under the curve (AUC0-∞) value 4.591 ± 0.163 µg/ml x h, elimination half-life (T1/2) 6.28 ± 0.71 h and elimination rate constant was found 0.110 ± 0.013 h-1. Results and Conclusion: Above evidences indicate that QS11 could serve as a lead for development of new antiepileptic drugs.

scholarly journals Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

2021 ◽  
Vol 09 (01) ◽  
pp. E9-E13
Author(s):  
Sachin Srinivasan ◽  
Peter D. Siersema ◽  
Madhav Desai
Keyword(s):  
Meta Analysis ◽  
Complete Removal ◽  
Colorectal Polyps ◽  
Comparable Efficacy ◽  
Incomplete Resection ◽  
Complication Rates ◽  
Biopsy Forceps ◽  
Significant Difference ◽  
Leave One Out ◽  
Endoscopic Assessment

Abstract Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue.

scholarly journals Preclinical Testing of Radiopharmaceuticals for the Detection and Characterization of Osteomyelitis: Experiences from a Porcine Model

Molecules ◽  
2021 ◽  
Vol 26 (14) ◽  
pp. 4221
Author(s):  
Aage Kristian Olsen Alstrup ◽  
Svend Borup Jensen ◽  
Ole Lerberg Nielsen ◽  
Lars Jødal ◽  
Pia Afzelius
Keyword(s):  
Animal Model ◽  
Animal Models ◽  
Porcine Model ◽  
Animal Experiments ◽  
Radioactive Tracers ◽  
The Individual ◽  
Selection Of

The development of new and better radioactive tracers capable of detecting and characterizing osteomyelitis is an ongoing process, mainly because available tracers lack selectivity towards osteomyelitis. An integrated part of developing new tracers is the performance of in vivo tests using appropriate animal models. The available animal models for osteomyelitis are also far from ideal. Therefore, developing improved animal osteomyelitis models is as important as developing new radioactive tracers. We recently published a review on radioactive tracers. In this review, we only present and discuss osteomyelitis models. Three ethical aspects (3R) are essential when exposing experimental animals to infections. Thus, we should perform experiments in vitro rather than in vivo (Replacement), use as few animals as possible (Reduction), and impose as little pain on the animal as possible (Refinement). The gain for humans should by far exceed the disadvantages for the individual experimental animal. To this end, the translational value of animal experiments is crucial. We therefore need a robust and well-characterized animal model to evaluate new osteomyelitis tracers to be sure that unpredicted variation in the animal model does not lead to a misinterpretation of the tracer behavior. In this review, we focus on how the development of radioactive tracers relies heavily on the selection of a reliable animal model, and we base the discussions on our own experience with a porcine model.

scholarly journals Animal Models in the Evaluation of the Effectiveness of Phage Therapy for Infections Caused by Gram-Negative Bacteria from the ESKAPE Group and the Reliability of Its Use in Humans

2021 ◽  
Vol 9 (2) ◽  
pp. 206
Author(s):  
Martyna Cieślik ◽  
Natalia Bagińska ◽  
Andrzej Górski ◽  
Ewa Jończyk-Matysiak
Keyword(s):  
Animal Models ◽  
Phage Therapy ◽  
Animal Experiments ◽  
Species Group ◽  
Effectiveness Evaluation ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Enterobacter Species ◽  
The Individual

The authors emphasize how extremely important it is to highlight the role played by animal models in an attempt to determine possible phage interactions with the organism into which it was introduced as well as to determine the safety and effectiveness of phage therapy in vivo taking into account the individual conditions of a given organism and its physiology. Animal models in which phages are used make it possible, among other things, to evaluate the effective therapeutic dose and to choose the possible route of phage administration depending on the type of infection developed. These results cannot be applied in detail to the human body, but the knowledge gained from animal experiments is invaluable and very helpful. We would like to highlight how useful animal models may be for the possible effectiveness evaluation of phage therapy in the case of infections caused by gram-negative bacteria from the ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species) group of pathogens. In this review, we focus specifically on the data from the last few years.

scholarly journals Graphene and Reproduction: A Love-Hate Relationship

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 547
Author(s):  
Marina Ramal-Sanchez ◽  
Antonella Fontana ◽  
Luca Valbonetti ◽  
Alessandra Ordinelli ◽  
Nicola Bernabò ◽  
...  
Keyword(s):  
Graphene Oxide ◽  
Reproductive Function ◽  
Scientometric Analysis ◽  
Potential Toxicity ◽  
Good Tool ◽  
Vitro Fertilization ◽  
Number Of Publications ◽  
The Individual

Since its discovery, graphene and its multiple derivatives have been extensively used in many fields and with different applications, even in biomedicine. Numerous efforts have been made to elucidate the potential toxicity derived from their use, giving rise to an adequate number of publications with varied results. On this basis, the study of the reproductive function constitutes a good tool to evaluate not only the toxic effects derived from the use of these materials directly on the individual, but also the potential toxicity passed on to the offspring. By providing a detailed scientometric analysis, the present review provides an updated overview gathering all the research studies focused on the use of graphene and graphene-based materials in the reproductive field, highlighting the consequences and effects reported to date from experiments performed in vivo and in vitro and in different animal species (from Archea to mammals). Special attention is given to the oxidized form of graphene, graphene oxide, which has been recently investigated for its ability to increase the in vitro fertilization outcomes. Thus, the potential use of graphene oxide against infertility is hypothesized here, probably by engineering the spermatozoa and thus manipulating them in a safer and more efficient way.

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