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Artif Intell Gastrointest Endosc. Dec 28, 2020; 1(3): 44-52
Published online Dec 28, 2020. doi: 10.37126/aige.v1.i3.44
Artificial intelligence assisted endocytoscopy: A novel eye in endoscopy
Monika Peshevska-Sekulovska, Tsvetelina Veselinova Velikova, Milena Peruhova
Monika Peshevska-Sekulovska, Milena Peruhova, Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Tsvetelina Veselinova Velikova, Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Tsvetelina Veselinova Velikova, Milena Peruhova, Medical Faculty, Sofia University, St. Kliment Ohridski, Sofia 1407, Bulgaria
Author contributions: Peshevska-Sekulovska M and Peruhova M wrote the draft of the manuscript; all the authors wrote additional sections in the paper, revised and approved the final version of the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Milena Peruhova, MD, Chief Doctor, Department of Gastroenterology, University Hospital Lozenetz, Kozyak 1 str., Sofia 1407, Bulgaria. mperuhova@gmail.com
Received: November 1, 2020
Peer-review started: November 1, 2020
First decision: November 25, 2020
Revised: November 29, 2020
Accepted: December 6, 2020
Article in press: December 6, 2020
Published online: December 28, 2020
Processing time: 57 Days and 7.4 Hours
Abstract

Over the past few years, emerging new approaches in endoscopic imaging technologies facilitate a high-quality assessment of lesions found in the gastrointestinal (GI) tract. Endocytoscopy (EC), as a novel tool in endoscopy, aids the more accurate evaluation of superficial mucosal surface. This review article aims to represent the most relevant information related to the latest EC technology and its clinical application in the lower GI tract diagnostic. We discuss EC-computer-aided diagnosis capability to differentiate between non-neoplastic and neoplastic lesion that offers a closer look to in-vivo assessment and diagnosis of cancerous tissue. Nevertheless, artificial-assisted EC diagnostics could also be employed with benefits in patients with inflammatory bowel disease (IBD) by accurately highlighting the presence of mucosal injury. In our review we included those studies comprising data about colonoscopy with narrow banding imaging and computer-aided diagnosis, as well as EC. Last but not least, artificial-assisted EC facilitates in-vivo diagnosis of the lower GI tract and may, in the future, remodel the field of in-vivo endoscopic diagnosis of colorectal lesions, representing another step towards the so-called optical biopsy.

Keywords: Endoscopic imaging; Endocytoscopy; Artificial intelligence; Artificial intelligence-assisted endoscopy; Colorectal cancer; Optical histology

Core Tip: The possibility of obtaining "real-time histology" by endocytoscopy (EC) provides a time-saving and low-cost high-quality diagnosing process. It provides detailed detection and characterizations of gastrointestinal neoplasms, where EC defines the degree of neoplastic cellular transformation by visualizing variation in cell size, disorders of polarity, and nuclei deformity. Moreover, the EC system can evaluate the depth of cancer invasion and predict the therapeutic outcome. In line with this, one of the significant benefits from artificial intelligence (AI)-supported EC is avoiding unnecessary polypectomies and other pathological examinations and reducing redundant surgical procedures. Another major benefit of AI-assisted EC is to ensure enhanced delineation between benign and neoplastic colonic lesions. Furthermore, emerging EC-computer-aided diagnosis provides a novel endoscopic tool that contributes to the dramatic improvement of inflammatory bowel disease diagnosing and management.