Artificial intelligence improves colonoscopies
There are more than a million colon cancer survivors in the U.S., according to the American Cancer Society.
That number is rising because doctors are finding and removing more precancerous polyps during colonoscopies, and the first “smarter scopes” in the United States are helping.
Every Friday, Dr. William Karnes has the help of an artificial intelligence system for colonoscopies at the University of California-Irvine. He’s helping develop the system, which operates similarly to facial recognition.
“We painstakingly drew little boxes around all those polyps on tens of thousands of images, and then trained the AI, tested the AI on its ability on a new set of images to find those polyps,” Karnes said.
Karnes says colonoscopists should find polyps in half of patients older than 50, but sometimes that rate is as low as 10 percent.
“It’s that gap between the prevalence of polyps and our ability to find them which is responsible for interval colon cancers," Karnes said. "These are cancers we get despite being up to date with colonoscopy.”
He said missed polyps result in 7 percent of colon cancers.
John Gifford volunteered to get an AI-assisted colonoscopy. It found two precancerous polyps that were removed.
“They were able to find something in its very formative stage, which was a relief because they found that, which means that they didn’t find anything else,” Gifford said.
Karnes said that, with the AI overlay, expert colonoscopists found 20 percent more polyps. He hopes upcoming clinical trials have similar results.
Karnes has tested the AI-assisted colonoscopies on about 100 patients so far. He hopes to begin multicenter clinical trials by next June.
TOPIC: ARTIFICIAL INTELLIGENCE IMPROVES COLONOSCOPIES
REPORT: MB #4515
BACKGROUND: Polyps are made up of abnormal tissue; they are growths that most often look like flat, small bumps or tiny mushroom-like stalks. They are most commonly found in the colon and are typically less than half an inch wide. Most are non-cancerous, but because they are a result of abnormal cell growth, they can eventually become malignant (cancerous). Your doctor can help determine if a growth is a polyp by performing a biopsy, which involves taking a sample of the tissue and testing for the presence of cancerous cells. Treatment depends on their size, location, and whether they are malignant or benign. Hyperplastic polyps are harmless, while adenomatous polyps are the most common and although most will not; they do have the potential to develop into colon cancer. Finally, malignant polyps are noted under microscopic exam to have cancer cells in them. In most cases polyps do not cause symptoms, but if you do experience symptoms they may include things like; blood in your stool, rectal bleeding, pain, diarrhea, or constipation, nausea or vomiting. Blood on your toilet tissue or blood-streaked stools may indicate rectal bleeding and should be evaluated by a doctor.
COLONOSCOPY: A colonoscopy is an exam used to determine changes or abnormalities in the large intestine, colon and rectum. A long, flexible tube referred to as a colonoscope is inserted into the rectum. There is a tiny video camera at the tip of the tube that allows doctors to view the entire inside of the colon. If needed, polyps and other types of abnormal tissues can be removed through the scope during a colonoscopy. Tissue samples or biopsies can also be taken. A colonoscopy may be recommended to you by your health provider to investigate intestinal signs and symptoms including abdominal pain or rectal bleeding. It may also be used to screen for colon cancer or search for more polyps if you have had them before, as a follow up procedure to confirm all were removed during the first procedure. They pose few risks, rarely complications may include; an adverse reaction to the sedative used during the exam, bleeding from the site where the tissue was taken, or a tear in the colon or rectal wall.
NEW TECHNOLOGY: The artificial intelligence colonoscopy, developed by doctors at the University of California Irvine (UCI), was designed to spot polyps that may be hard for the doctors themselves to catch the first time around. Dr. William Karnes, a gastroenterologist at UCI Health says the AI colonoscopy has the ability to identify up to 20 percent more abnormalities than the average, traditional test. The system uses complicated algorithms and analyzes more than 98 images per second as it searches for not only just polyps but even possible tissue that could become one. The program shows its results to the doctors in real time during the colonoscopy procedure. It may actually help identify those that they would otherwise miss, sometimes these polyps found with AI may not have been detected or show up during traditional procedures for up to five more years. This could mean the difference between colon cancer prevention and colon cancer treatment.