Semi-supervised Quality Evaluation of Colonoscopy Procedures

Colonoscopy is the standard of care technique for detecting and removing polyps for the prevention of colorectal cancer. Nevertheless, gastroenterologists (GI) routinely miss approximately 25% of polyps during colonoscopies. These misses are highly operator dependent, influenced by the physician skills, experience, vigilance, and fatigue. Standard quality metrics, such as Withdrawal Time or Cecal Intubation Rate, have been shown to be well correlated with Adenoma Detection Rate (ADR). However, those metrics are limited in their ability to assess the quality of a specific procedure, and they do not address quality aspects related to the style or technique of the examination. In this work we design novel online and offline quality metrics, based on visual appearance quality criteria learned by an ML model in an unsupervised way. Furthermore, we evaluate the likelihood of detecting an existing polyp as a function of procedure quality and use it to demonstrate high correlation of the proposed metric to polyp detection sensitivity. The proposed online quality metric can be used to provide real time quality feedback to the performing GI. By integrating the local metric over the withdrawal phase, we build a global, offline quality metric, which is shown to be highly correlated to the standard Polyp Per Colonoscopy (PPC) quality metric.