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In Gastrointestinal endoscopy ; h5-index 72.0

BACKGROUND AND AIMS : Colorectal cancer is a leading cause of death. Colonoscopy is the criterion standard for detection and removal of precancerous lesions and has been shown to reduce mortality. The polyp miss rate during colonoscopies is 22% to 28%. DEEP DEtection of Elusive Polyps (DEEP2) is a new polyp detection system based on deep learning, which alerts the operator in real-time to the presence and location of polyps. The primary outcome was the performance of DEEP2 on the detection of elusive polyps.

METHODS : The DEEP2 system was trained on 3,611 hours of colonoscopy videos derived from 2 sources, and was validated on a set comprising 1,393 hours, from a third unrelated source. The ground truth labeling was provided by offline gastroenterologist annotators, who were able to watch the video in slow-motion and pause/rewind as required. To assess the applicability, stability, user experience and in order to obtain some preliminary data on performance in a real-life scenario, a preliminary prospective clinical validation study was performed, comprising 100 procedures ( ID: NCT04693078).

RESULTS : DEEP2 achieved a sensitivity of 97.1% at 4.6 false alarms per video for all polyps, 88.5% and 84.9% for polyps that are in the field of view for less than 5 and 2 seconds, respectively. DEEP2 was able to detect polyps, not seen by live real-time endoscopists or offline annotators in an average of 0.22 polyps per sequence. In the clinical validation study the system detected an average of 0.89 additional polyps per procedure. No adverse events occurred.

CONCLUSIONS : DEEP2 has a high sensitivity for polyp detection and was effective in increasing the detection of polyps both in colonoscopy videos and in real procedures with a low number of false alarms.

Livovsky Dan M, Veikherman Danny, Golany Tomer, Aides Amit, Dashinsky Valentin, Rabani Nadav, Ben Shimol David, Blau Yochai, Katzir Liran, Shimshoni Ilan, Liu Yun, Segol Ori, Goldin Eran, Corrado Greg, Lachter Jesse, Matias Yossi, Rivlin Ehud, Freedman Daniel