Can artificial intelligence help to detect dysplasia in patients with ulcerative colitis?

A 72-year-old man with an 18-year history of pancolitis had been visiting our hospital regularly for 12 years. He was taking oral mesalamine and mercaptopurine to sustain clinical remission. Surveillance colonoscopy was performed using high-definition endoscopy (CF-HQ290ZI; Olympus, Tokyo, Japan) with an artificial intelligence (AI)-based detection system (EndoBRAIN-EYE; Cybernet Systems, Tokyo, Japan). The AI-based detection system identified two lesions in the sigmoid colon ([ Fig. 1 a, b ]) and indicated them with bounding boxes ([ Video 1 ]). Fig. 1 The artificial intelligence-based detection system identified dysplasia. a First lesion. b Second lesion. Video 1 At the moment the artificial intelligence-based detection system identified the dysplasia, it displayed the four corners of the monitor in yellow and indicated boxes bounding the dysplasia. Quality: mobile 360 480 720 Download Histological examination of the biopsy specimens showed that both of the lesions were characterized by low-grade dysplasia ([ Fig. 2 a, b ]). Fig. 2 Histological examination showed an atypical tubular gland with low-grade dysplasia. a First lesion. b Second lesion. Patients with longstanding ulcerative colitis (UC) have a higher risk of colorectal cancer than do individuals in the general population [ 1 ]. UC-associated dysplasia is often flat with an unclear boundary from the surrounding tissues, making it difficult to detect [ 2 ]. AI-based polyp detection systems are used during colonoscopy to increase lesion detection [ 3 ]. The EndoBRAIN-EYE system can reportedly identify colorectal lesions with high accuracy in non-UC patients [ 4 ] [ 5 ]. However, its use for the detection of dysplasia in patients with UC has not been previously reported. With a target biopsy strategy in UC surveillance, the ability to detect lesions depends on the endoscopist. AI has the potential to help non-expert endoscopists detect dysplasia in patients with UC. Endoscopy_UCTN_Code_TTT_1AQ_2AB Endoscopy E-Videos https://eref.thieme.de/e-videos Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. This section has its own submission website at https://mc.manuscriptcentral.com/e-videos Publication History Article published online: 01 October 2020 © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany