Updates in narrow-band imaging for colorectal polyps: Narrow-band imaging generations, detection, diagnosis, and artificial intelligence.
adenoma detection rate
blue laser imaging
colonoscopy
image enhanced endoscopy
narrow band imaging
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
29
06
2022
accepted:
01
12
2022
medline:
15
5
2023
pubmed:
9
12
2022
entrez:
8
12
2022
Statut:
ppublish
Résumé
Narrow-band imaging (NBI) is an optical digital enhancement method that allows the observation of vascular and surface structures of colorectal lesions. Its usefulness in the detection and diagnosis of colorectal polyps has been demonstrated in several clinical trials and the diagnostic algorithms have been simplified after the establishment of endoscopic classifications such as the Japan NBI Expert Team classification. However, there were issues including lack of brightness in the earlier models, poor visibility under insufficient bowel preparation, and the incompatibility of magnifying endoscopes in certain endoscopic platforms, which had impeded NBI from becoming standardized globally. Nonetheless, NBI continued its evolution and the newest endoscopic platform launched in 2020 offers significantly brighter and detailed images. Enhanced visualization is expected to improve the detection of polyps while universal compatibility across all scopes including magnifying endoscopy will promote the global standardization of magnifying diagnosis. Therefore, knowledge related to magnifying colonoscopy will become essential as magnification becomes standardly equipped in future models, although the advent of computer-aided diagnosis and detection may greatly assist endoscopists to ensure quality of practice. Given that most endoscopic departments will be using both old and new models, it is important to understand how each generation of endoscopic platforms differ from each other. We reviewed the advances in the endoscopic platforms, artificial intelligence, and evidence related to NBI essential for the next generation of endoscopic practice.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
453-470Informations de copyright
© 2022 Japan Gastroenterological Endoscopy Society.
Références
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut 2017; 66: 683-91.
Zauber AG, Winawer SJ, O'Brien MJ et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 2012; 366: 687-96.
Corley DA, Jensen CD, Marks AR et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-306.
Gono K, Obi T, Yamaguchi M et al. Appearance of enhanced tissue features in narrow-band endoscopic imaging. J Biomed Opt 2004; 9: 568-77.
Sano Y, Kobayashi M, Kozu T. Development and clinical application of a narrow band imaging (NBI) system with builtin narrow-band RGB filters. Stomach Intest 2001; 36: 1283-7. Japanese.
Yoshida N, Sano Y. History, clinical application, and future perspective of narrow band imaging and blue laser imaging. Dig Endosc 2022; 34: 86-90.
Gono K. Narrow band imaging: Technology basis and research and development history. Clin Endosc 2015; 48: 476-80.
Muto M, Minashi K, Yano T et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: A multicenter randomized controlled trial. J Clin Oncol 2010; 28: 1566-72.
Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy 2009; 41: 462-7.
Machida H, Sano Y, Hamamoto Y et al. Narrow-band imaging in the diagnosis of colorectal mucosal lesions: A pilot study. Endoscopy 2004; 36: 1094-8.
Sano Y, Ikematsu H, Fu KI et al. Meshed capillary vessels by use of narrow-band imaging for differential diagnosis of small colorectal polyps. Gastrointest Endosc 2009; 69: 278-83.
Bruno C, Pollastri F, Locatello LG et al. Otoendoscopic characterisation of middle ear masses by the aid of narrow-band imaging: A preliminary report. Clin Otolaryngol 2021; 46: 1315-8.
Bruno C, Fiori GM, Locatello LG, Cannavicci A, Gallo O, Maggiore G. The role of narrow band imaging (NBI) in the diagnosis of sinonasal diseases. Rhinology 2021; 59: 40-8.
Russo GI, Sholklapper TN, Cocci A et al. Performance of narrow band imaging (NBI) and photodynamic diagnosis (PDD) fluorescence imaging compared to white light cystoscopy (WLC) in detecting non-muscle invasive bladder cancer: A systematic review and lesion-level diagnostic meta-analysis. Cancers (Basel) 2021; 13: 4378.
Uchita K, Kanenishi K, Hirano K et al. Characteristic findings of high-grade cervical intraepithelial neoplasia or more on magnifying endoscopy with narrow band imaging. Int J Clin Oncol 2018; 23: 707-14.
Kobara H, Uchita K, Uedo N et al. Flexible magnifying endoscopy with narrow band imaging for diagnosing uterine cervical neoplasms: A multicenter prospective study. J Clin Med 2021; 10: 4753.
De Luca L, Ricciardiello L, Rocchi MB et al. Narrow band imaging with magnification endoscopy for celiac disease: Results from a prospective, single-center study. Diagn Ther Endosc 2013; 2013: 580526.
Mani S, Bharagava RN. Exposure to crystal violet, its toxic, genotoxic and carcinogenic effects on environment and its degradation and detoxification for environmental safety. Rev Environ Contam Toxicol 2016; 237: 71-104.
Atkinson NSS, Ket S, Bassett P et al. Narrow-band imaging for detection of neoplasia at colonoscopy: A meta-analysis of data from individual patients in randomized controlled trials. Gastroenterology 2019; 157: 462-71.
Progress in medical devices for gastrointestinal endoscopy: Olympus Inc. Dig Endosc 2022; 34 (Suppl 2): 138-42.
ASGE Technology Committee. High-definition and high-magnification endoscopes. Gastrointest Endosc 2014; 80: 919-27.
East JE, Vleugels JL, Roelandt P et al. Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review. Endoscopy 2016; 48: 1029-45.
East JE, Saunders BP, Burling D, Boone D, Halligan S, Taylor SA. Surface visualization at CT colonography simulated colonoscopy: Effect of varying field of view and retrograde view. Am J Gastroenterol 2007; 102: 2529-35.
Bond A, O'Toole P, Fisher G et al. New-generation high-definition colonoscopes increase adenoma detection when screening a moderate-risk population for colorectal cancer. Clin Colorectal Cancer 2017; 16: 44-50.
Sato T. TXI: Texture and color enhancement imaging for endoscopic image enhancement. J Healthc Eng 2021; 2021: 5518948.
Fujimoto A, Saito Y, Abe S et al. Clinical usefulness of red dichromatic imaging in hemostatic treatment during endoscopic submucosal dissection: First report from a multicenter, open-label, randomized controlled trial. Dig Endosc 2022; 34: 379-90.
Progress in medical devices for gastrointestinal endoscopy: FUJIFILM Corporation. Dig Endosc 2022; 34 (Suppl 2): 143-7.
Yoshida N, Hisabe T, Inada Y et al. The ability of a novel blue laser imaging system for the diagnosis of invasion depth of colorectal neoplasms. J Gastroenterol 2014; 49: 73-80.
Yoshida N, Yagi N, Inada Y et al. Ability of a novel blue laser imaging system for the diagnosis of colorectal polyps. Dig Endosc 2014; 26: 250-8.
Ikematsu H, Sakamoto T, Togashi K et al. Detectability of colorectal neoplastic lesions using a novel endoscopic system with blue laser imaging: A multicenter randomized controlled trial. Gastrointest Endosc 2017; 86: 386-94.
Ang TL, Li JW, Wong YJ et al. A prospective randomized study of colonoscopy using blue laser imaging and white light imaging in detection and differentiation of colonic polyps. Endosc Int Open 2019; 7: E1207-13.
Nakano A, Hirooka Y, Yamamura T et al. Comparison of the diagnostic ability of blue laser imaging magnification versus pit pattern analysis for colorectal polyps. Endosc Int Open 2017; 5: E224-31.
Higurashi T, Ashikari K, Tamura S et al. Comparison of the diagnostic performance of NBI, laser-BLI and LED-BLI: A randomized controlled noninferiority trial. Surg Endosc 2022; 36: 7577-87.
Subramaniam S, Hayee B, Aepli P et al. Optical diagnosis of colorectal polyps with blue light imaging using a new international classification. United European Gastroenterol J 2019; 72: 316-25.
Inoue T, Murano M, Murano N et al. Comparative study of conventional colonoscopy and pan-colonic narrow-band imaging system in the detection of neoplastic colonic polyps: A randomized, controlled trial. J Gastroenterol 2008; 43: 45-50.
Kaltenbach T, Friedland S, Soetikno R. A randomised tandem colonoscopy trial of narrow band imaging versus white light examination to compare neoplasia miss rates. Gut 2008; 5: 1406-12.
Adler A, Pohl H, Papanikolaou IS et al. A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: Does narrow-band imaging induce a learning effect? Gut 2008; 57: 59-64.
Rex DK, Helbig CC. High yields of small and flat adenomas with high-definition colonoscopes using either white light or narrow band imaging. Gastroenterology 2007; 133: 42-7.
Ikematsu H, Saito Y, Tanaka S et al. The impact of narrow band imaging for colon polyp detection: A multicenter randomized controlled trial by tandem colonoscopy. J Gastroenterol 2012; 47: 1099-107.
Paggi S, Radaelli F, Amato A et al. The impact of narrow band imaging in screening colonoscopy: A randomized controlled trial. Clin Gastroenterol Hepatol 2009; 7: 1049-54.
East JE, Ignjatovic A, Suzuki N et al. A randomized, controlled trial of narrow-band imaging vs high-definition white light for adenoma detection in patients at high risk of adenomas. Colorectal Dis 2012; 14: E771-8.
Rastogi A, Early DS, Gupta N et al. Randomized, controlled trial of standard-definition white-light, high-definition white-light, and narrow-band imaging colonoscopy for the detection of colon polyps and prediction of polyp histology. Gastrointest Endosc 2011; 74: 593-602.
Senore C, Reggio D, Musso A et al. Narrow band imaging vs. high definition colonoscopy for detection of colorectal adenomas in patients with positive faecal occult blood test: A randomised trial. Dig Liver Dis 2014; 46: 803-7.
Sabbagh LC, Reveiz L, Aponte D, de Aguiar S. Narrow-band imaging does not improve detection of colorectal polyps when compared to conventional colonoscopy: A randomized controlled trial and meta-analysis of published studies. BMC Gastroenterol 2011; 11: 100.
Adler A, Aschenbeck J, Yenerim T et al. Narrow-band versus white-light high definition television endoscopic imaging for screening colonoscopy: A prospective randomized trial. Gastroenterology 2009; 136: 410-6.
Dinesen L, Chua TJ, Kaffes AJ. Meta-analysis of narrow-band imaging versus conventional colonoscopy for adenoma detection. Gastrointest Endosc 2012; 75: 604-11.
Pasha SF, Leighton JA, Das A et al. Comparison of the yield and miss rate of narrow band imaging and white light endoscopy in patients undergoing screening or surveillance colonoscopy: A meta-analysis. Am J Gastroenterol 2012; 107: 363-70.
Jin XF, Chai TH, Shi JW, Yang XC, Sun QY. Meta-analysis for evaluating the accuracy of endoscopy with narrow band imaging in detecting colorectal adenomas. J Gastroenterol Hepatol 2012; 27: 882-7.
Leung WK, Lo OS, Liu KS et al. Detection of colorectal adenoma by narrow band imaging (HQ190) vs. high-definition white light colonoscopy: A randomized controlled trial. Am J Gastroenterol 2014; 109: 855-63.
Chung SJ, Kim D, Song JH et al. Comparison of detection and miss rates of narrow band imaging, flexible spectral imaging chromoendoscopy and white light at screening colonoscopy: A randomised controlled back-to-back study. Gut 2014; 63: 785-91.
Leung WK, Guo CG, Ko MKL et al. Linked color imaging versus narrow-band imaging for colorectal polyp detection: A prospective randomized tandem colonoscopy study. Gastrointest Endosc 2020; 91: 104-12.e5.
Sumimoto K, Tanaka S, Shigita K et al. Diagnostic performance of Japan NBI expert team classification for differentiation among noninvasive, superficially invasive, and deeply invasive colorectal neoplasia. Gastrointest Endosc 2017; 86: 700-9.
Minamide T, Sashiyama H, Muramatsu Y et al. Second-generation narrow-band imaging to detect colorectal adenomas: A prospective study including community hospitals. J Gastroenterol Hepatol 2021; 36: 3084-91.
Kim H, Goong HJ, Ko BM et al. Randomized, back-to-back trial of a new generation NBI with a high-definition white light (HQ290) for detecting colorectal polyps. Scand J Gastroenterol 2019; 54: 1058-63.
Staudenmann D, Liu K, Varma P et al. Narrow band imaging versus white light for detecting sessile serrated lesion: A prospective randomized multicenter study. DEN Open 2022; 2: e44.
Hazewinkel Y, Tytgat KM, van Leerdam ME et al. Narrow-band imaging for the detection of polyps in patients with serrated polyposis syndrome: A multicenter, randomized, back-to-back trial. Gastrointest Endosc 2015; 81: 531-8.
Riu Pons F, Andreu M, Naranjo D et al. Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome: A randomized controlled trial with tandem colonoscopy. BMC Gastroenterol 2020; 20: 111.
Rex DK, Clodfelter R, Rahmani F et al. Narrow-band imaging versus white light for the detection of proximal colon serrated lesions: A randomized, controlled trial. Gastrointest Endosc 2016; 83: 166-71.
Kudo S, Tamura S, Nakajima T, Yamano H, Kusaka H, Watanabe H. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc 1996; 44: 8-14.
Kudo S, Hirota S, Nakajima T et al. Colorectal tumours and pit pattern. J Clin Pathol 1994; 47: 880-5.
Hirata M, Tanaka S, Oka S et al. Magnifying endoscopy with narrow band imaging for diagnosis of colorectal tumors. Gastrointest Endosc 2007; 65: 988-95.
Kanao H, Tanaka S, Oka S, Hirata M, Yoshida S, Chayama K. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc 2009; 69: 631-6.
Wada Y, Kudo SE, Kashida H et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastrointest Endosc 2009; 70: 522-31.
Saito S, Tajiri H, Ohya T, Nikami T, Aihara H, Ikegami M. The benefit of using narrow-band imaging systems for observation of capillary networks before determining of treatments for early colon cancer. Dig Endosc 2011; 23: 120-5.
Iwatate M, Sano Y, Tanaka S et al. Validation study for development of the Japan NBI expert team classification of colorectal lesions. Dig Endosc 2018; 30: 642-51.
Koyama Y, Fukuzawa M, Kono S et al. Diagnostic efficacy of the Japan NBI expert team classification with dual-focus magnification for colorectal tumors. Surg Endosc 2022; 36: 5032-40.
Zhang Y, Chen HY, Zhou XL, Pan WS, Zhou XX, Pan HH. Diagnostic efficacy of the Japan narrow-band-imaging expert team and pit pattern classifications for colorectal lesions: A meta-analysis. World J Gastroenterol 2020; 26: 6279-94.
Ladabaum U, Fioritto A, Mitani A et al. Real-time optical biopsy of colon polyps with narrow band imaging in community practice does not yet meet key thresholds for clinical decisions. Gastroenterology 2013; 144: 81-91.
Zhou QJ, Yang JM, Fei BY, Xu QS, Wu WQ, Ruan HJ. Narrow-band imaging endoscopy with and without magnification in diagnosis of colorectal neoplasia. World J Gastroenterol 2011; 17: 666-70.
Lee CK, Lee SH, Hwangbo Y. Narrow-band imaging versus I-Scan for the real-time histological prediction of diminutive colonic polyps: A prospective comparative study by using the simple unified endoscopic classification. Gastrointest Endosc 2011; 74: 603-9.
Ignjatovic A, East JE, Guenther T et al. What is the most reliable imaging modality for small colonic polyp characterization? Study of white-light, autofluorescence, and narrow-band imaging. Endoscopy 2011; 43: 94-9.
Rex DK. Narrow-band imaging without optical magnification for histologic analysis of colorectal polyps. Gastroenterology 2009; 136: 1174-81.
Rastogi A, Keighley J, Singh V et al. High accuracy of narrow band imaging without magnification for the real-time characterization of polyp histology and its comparison with high-definition white light colonoscopy: A prospective study. Am J Gastroenterol 2009; 104: 2422-30.
Sikka S, Ringold DA, Jonnalagadda S, Banerjee B. Comparison of white light and narrow band high definition images in predicting colon polyp histology, using standard colonoscopes without optical magnification. Endoscopy 2008; 40: 818-22.
Rogart JN, Jain D, Siddiqui UD et al. Narrow-band imaging without high magnification to differentiate polyps during real-time colonoscopy: Improvement with experience. Gastrointest Endosc 2008; 68: 1136-45.
McGill SK, Evangelou E, Ioannidis JP, Soetikno RM, Kaltenbach T. Narrow band imaging to differentiate neoplastic and non-neoplastic colorectal polyps in real time: A meta-analysis of diagnostic operating characteristics. Gut 2013; 62: 1704-13.
Mason SE, Poynter L, Takats Z, Darzi A, Kinross JM. Optical technologies for endoscopic real-time histologic assessment of colorectal polyps: A meta-analysis. Am J Gastroenterol 2019; 114: 1219-30.
Hewett DG, Kaltenbach T, Sano Y et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology 2012; 143: 599-607.e1.
Hayashi N, Tanaka S, Hewett DG et al. Endoscopic prediction of deep submucosal invasive carcinoma: Validation of the narrow-band imaging international colorectal endoscopic (NICE) classification. Gastrointest Endosc 2013; 78: 625-32.
Rees CJ, Rajasekhar PT, Wilson A et al. Narrow band imaging optical diagnosis of small colorectal polyps in routine clinical practice: The detect inspect characterise resect and discard 2 (DISCARD 2) study. Gut 2017; 66: 887-95.
Puig I, Lopez-Ceron M, Arnau A et al. Accuracy of the narrow-band imaging international colorectal endoscopic classification system in identification of deep invasion in colorectal polyps. Gastroenterology 2019; 156: 75-87.
Pai R, Mäkinen M, Rosty C. Colorectal serrated lesions and polyps. In: Nagtegaal ID, Arends MJ, Odze RD, Lam AK (eds). WHO Classification of Tumours of the Digestive System, Lyon: IARC Press, 2019; 163-9.
Kimura T, Yamamoto E, Yamano HO et al. A novel pit pattern identifies the precursor of colorectal cancer derived from sessile serrated adenoma. Am J Gastroenterol 2012; 107: 460-9.
Yamashina T, Takeuchi Y, Uedo N et al. Diagnostic features of sessile serrated adenoma/polyps on magnifying narrow band imaging: A prospective study of diagnostic accuracy. J Gastroenterol Hepatol 2015; 30: 117-23.
Nakao Y, Saito S, Ohya T et al. Endoscopic features of colorectal serrated lesions using image-enhanced endoscopy with pathological analysis. Eur J Gastroenterol Hepatol 2013; 25: 981-8.
Uraoka T, Higashi R, Horii J et al. Prospective evaluation of endoscopic criteria characteristic of sessile serrated adenomas/polyps. J Gastroenterol 2015; 50: 555-63.
Hazewinkel Y, Lopez-Ceron M, East JE et al. Endoscopic features of sessile serrated adenomas: Validation by international experts using high-resolution white-light endoscopy and narrow-band imaging. Gastrointest Endosc 2013; 77: 916-24.
IJspeert JE, Bastiaansen BA, van Leerdam ME et al. Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut 2016; 65: 963-70.
Parikh ND, Chaptini L, Njei B, Laine L. Diagnosis of sessile serrated adenomas/polyps with image-enhanced endoscopy: A systematic review and meta-analysis. Endoscopy 2016; 48: 731-9.
Gourevitch RA, Rose S, Crockett SD et al. Variation in pathologist classification of colorectal adenomas and serrated polyps. Am J Gastroenterol 2018; 113: 431-9.
Niv Y. Changing pathological diagnosis from hyperplastic polyp to sessile serrated adenoma: Systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2017; 29: 1327-31.
Chino A, Yamamoto N, Kato Y et al. The frequency of early colorectal cancer derived from sessile serrated adenoma/polyps among 1858 serrated polyps from a single institution. Int J Colorectal Dis 2016; 31: 343-9.
Saiki H, Nishida T, Yamamoto M et al. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection. Endosc Int Open 2016; 4: E451-8.
Lash RH, Genta RM, Schuler CM. Sessile serrated adenomas: Prevalence of dysplasia and carcinoma in 2139 patients. J Clin Pathol 2010; 63: 681-6.
Sano W, Sano Y, Iwatate M et al. Prospective evaluation of the proportion of sessile serrated adenoma/polyps in endoscopically diagnosed colorectal polyps with hyperplastic features. Endosc Int Open 2015; 3: E354-8.
Tate DJ, Jayanna M, Awadie H et al. A standardized imaging protocol for the endoscopic prediction of dysplasia within sessile serrated polyps (with video). Gastrointest Endosc 2018; 87: 222-31.e2.
Murakami T, Sakamoto N, Fukushima H, Shibuya T, Yao T, Nagahara A. Usefulness of the Japan narrow-band imaging expert team classification system for the diagnosis of sessile serrated lesion with dysplasia/carcinoma. Surg Endosc 2021; 35: 4528-38.
Sano Y, Saito Y, Fu K-I et al. Efficacy of magnifying chromoendoscopy for the differential diagnosis of colorectal lesions. Dig Endosc 2005; 17: 105-16.
Kashida H. Endoscopic diagnosis of sessile serrated polyp: A systematic review. Dig Endosc 2019; 31: 16-23.
Sano W, Hirata D, Teramoto A et al. Serrated polyps of the colon and rectum: Remove or not? World J Gastroenterol 2020; 26: 2276-85.
Barua I, Vinsard DG, Jodal HC et al. Artificial intelligence for polyp detection during colonoscopy: A systematic review and meta-analysis. Endoscopy 2021; 53: 277-84.
Hann A, Troya J, Fitting D. Current status and limitations of artificial intelligence in colonoscopy. United European Gastroenterol J 2021; 9: 527-33.
Tischendorf JJ, Gross S, Winograd R et al. Computer-aided classification of colorectal polyps based on vascular patterns: A pilot study. Endoscopy 2010; 42: 203-7.
Gross S, Trautwein C, Behrens A et al. Computer-based classification of small colorectal polyps by using narrow-band imaging with optical magnification. Gastrointest Endosc 2011; 74: 1354-9.
Takemura Y, Yoshida S, Tanaka S et al. Computer-aided system for predicting the histology of colorectal tumors by using narrow-band imaging magnifying colonoscopy (with video). Gastrointest Endosc 2012; 75: 179-85.
Kominami Y, Yoshida S, Tanaka S et al. Computer-aided diagnosis of colorectal polyp histology by using a real-time image recognition system and narrow-band imaging magnifying colonoscopy. Gastrointest Endosc 2016; 83: 643-9.
Rex DK, Kahi C, O'Brien M et al. The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc 2011; 73: 419-22.
Mori Y, Kudo SE, Wakamura K et al. Novel computer-aided diagnostic system for colorectal lesions by using endocytoscopy (with videos). Gastrointest Endosc 2015; 81: 621-9.
Mori Y, Kudo SE, Chiu PW et al. Impact of an automated system for endocytoscopic diagnosis of small colorectal lesions: An international web-based study. Endoscopy 2016; 48: 1110-8.
Misawa M, Kudo SE, Mori Y et al. Characterization of colorectal lesions using a computer-aided diagnostic system for narrow-band imaging endocytoscopy. Gastroenterology 2016; 150: 1531-2.e3.
Misawa M, Kudo SE, Mori Y et al. Accuracy of computer-aided diagnosis based on narrow-band imaging endocytoscopy for diagnosing colorectal lesions: Comparison with experts. Int J Comput Assist Radiol Surg 2017; 12: 757-66.
Mori Y, Kudo SE, Misawa M et al. Real-time use of artificial intelligence in identification of diminutive polyps during colonoscopy: A prospective study. Ann Intern Med 2018; 169: 357-66.
Barua I, Wieszczy P, Kudo SE et al. Real-time artificial intelligence-based optical diagnosis of neoplastic polyps during colonoscopy. NEJM Evidence 2022; 1: EVIDoa2200003.
Song EM, Park B, Ha CA et al. Endoscopic diagnosis and treatment planning for colorectal polyps using a deep-learning model. Sci Rep 2020; 10: 30.
Okamoto Y, Yoshida S, Izakura S et al. Development of multi-class computer-aided diagnostic systems using the NICE/JNET classifications for colorectal lesions. J Gastroenterol Hepatol 2022; 37: 104-10.
Byrne MF, Chapados N, Soudan F et al. Real-time differentiation of adenomatous and hyperplastic diminutive colorectal polyps during analysis of unaltered videos of standard colonoscopy using a deep learning model. Gut 2019; 68: 94-100.
Zorron Cheng Tao Pu L, Maicas G, Tian Y et al. Computer-aided diagnosis for characterization of colorectal lesions: Comprehensive software that includes differentiation of serrated lesions. Gastrointest Endosc 2020; 92: 891-9.
Zachariah R, Samarasena J, Luba D et al. Prediction of polyp pathology using convolutional neural networks achieves “resect and discard” thresholds. Am J Gastroenterol 2020; 115: 138-44.