OP16 The first virtual chromoendoscopy artificial intelligence system to detect endoscopic and histologic remission in Ulcerative Colitis

Conference paper

Iacucci, M, Cannatelli, R, Parigi, TL, Buda, A, Labarile, N, Nardone, OM, Tontini, GE, Rimondi, A, Bazarova, A, Bhandari, P, Bisschops, R, De Hertogh, G, Del Amor, R, Ferraz, JG, Goetz, M, Gui, X, Hayee, B, Kiesslich, R, Lazarev, M, Naranjo, V, Panaccione, R, Parra-Blanco, A, Pastorelli, L, Rath, T, Røyset, ES, Vieth, M, Villanacci, V, Zardo, D, Ghosh, S and Grisan, E. (2022). OP16 The first virtual chromoendoscopy artificial intelligence system to detect endoscopic and histologic remission in Ulcerative Colitis. 17th Congress of ECCO - European Crohn’s and Colitis Organisation. 16 - 19 Feb 2022 Oxford University Press (OUP). https://doi.org/10.1093/ecco-jcc/jjab232.015
AuthorsIacucci, M, Cannatelli, R, Parigi, TL, Buda, A, Labarile, N, Nardone, OM, Tontini, GE, Rimondi, A, Bazarova, A, Bhandari, P, Bisschops, R, De Hertogh, G, Del Amor, R, Ferraz, JG, Goetz, M, Gui, X, Hayee, B, Kiesslich, R, Lazarev, M, Naranjo, V, Panaccione, R, Parra-Blanco, A, Pastorelli, L, Rath, T, Røyset, ES, Vieth, M, Villanacci, V, Zardo, D, Ghosh, S and Grisan, E.
TypeConference paper
Abstract

Background
Endoscopic and histologic activity are important therapeutic targets in ulcerative colitis (UC). The Paddington International Virtual ChromoendoScopy ScOre (VCE-PICaSSO)1 demonstrated that enhanced visualisation of subtle mucosal and vascular inflammatory changes correlated strongly with histology. However, without adequate training, the subjective evaluation of white light (WL) and VCE endoscopic scores varies between observers. We aimed to develop an artificial intelligence (AI) system for objective assessment of endoscopic disease activity and predict histology related to both white light and VCE videos.

Methods
469 endoscopy videos (48512 frames) from 235 patients representative of all grades of inflammation, from our prospective PICaSSO multicentre study1 were used to develop a convolutional neural network (CNN). 316 videos were divided into training (254) and validation (62) sets. 153 additional videos (78 patients) were used as test cohort. The videos were edited to separate clips with WL and with VCE, and assessed using Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and PICaSSO, respectively. The classification stage of a pre-trained ResNet50 CNN classifier was trained to predict the healing or active inflammation on video frames. One network was trained to predict endoscopic remission (ER) as UCEIS≤1 from WL frames, and a second network was trained to predict PICaSSO≤3 from VCE. Histological remission (HR) was defined as Robarts Histological Index (RHI) ≤3 with no neutrophils in lamina propria or epithelium.

Results
In the validation cohort, our system predicted ER (UCEIS ≤1) in WL videos with 82% sensitivity (Se), 94% specificity (Sp) and an area under the ROC curve (AUROC) of 0.92. For the detection of remission in VCE videos (PICaSSO ≤3) Se was 74%, Sp 95%, and AUROC 0.95. In the testing cohort of independent videos, the diagnostic performance for both cut offs of ER remained similar.

Our system also had an excellent diagnostic performance for the prediction of HR in the validation set, with Se, Sp, and Accuracy of 92%, 83%, and 85% respectively, using VCE, and 83%, 87%, and 86% respectively, with WL. In the testing set performance declined modestly while remaining good. Of note, the algorithm’s prediction of histology was similar with VCE and WL videos.

Year2022
JournalJournal of Crohn's and Colitis
PublisherOxford University Press (OUP)
Journal citation16 (Suppl 1), p. i017–i018
Digital Object Identifier (DOI)https://doi.org/10.1093/ecco-jcc/jjab232.015
Web address (URL)https://academic.oup.com/ecco-jcc/article/16/Supplement_1/i017/6512535?login=true
Accepted author manuscript
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Open
Publication dates
Print21 Jan 2022
Publication process dates
Deposited24 Feb 2022
Accepted17 Dec 2021
Additional information

This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Crohn's and Colitis following peer review. The version of record is available online at: https://doi.org/10.1093/ecco-jcc/jjab232.015

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Peruffo, A., Corain, L., Bombardi, C., Centelleghe, C., Grisan, E., Graïc, J-M, Bontempi, P., Grandis, A. and Cozzi, B. (2019). The motor cortex of the sheep: laminar organization, projections and diffusion tensor imaging of the intracranial pyramidal and extrapyramidal tracts. Brain Structure and Function. 224 (5), pp. 1933-1946. https://doi.org/10.1007/s00429-019-01885-x
Building a reduced dictionary of relevant perfusion patterns from CEUS data for the classification of testis lesions
Favaron, T., Huang, D.Y., Christensen-Jeffries, K., Eckersley, R., Sidhu, P.S. and Grisan, E. (2019). Building a reduced dictionary of relevant perfusion patterns from CEUS data for the classification of testis lesions. 2019 IEEE 16th International Symposium on Biomedical Imaging. Venice, Italy 08 - 11 Apr 2019 Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/ISBI.2019.8759528
Deep Convolutional Neural Network for Survival Estimation of Amyotrophic Lateral Sclerosis patients
Grisan, E., Zandon`a, A. and Di Camillo, B. (2019). Deep Convolutional Neural Network for Survival Estimation of Amyotrophic Lateral Sclerosis patients. European Symposium on Artificial Neural Networks, Computational Intelligence and Machine Learning. Bruges, Belgium 24 - 26 Apr 2019 i6doc.
Prediction of Adverse Glycemic Events from Continuous Glucose Monitoring Signal
Gadaleta, M., Facchinetti, A., Grisan, E. and Rossi, M. (2019). Prediction of Adverse Glycemic Events from Continuous Glucose Monitoring Signal. IEEE Journal of Biomedical and Health Informatics. 23 (2). https://doi.org/10.1109/JBHI.2018.2823763
Sparse Image Reconstruction for Contrast Enhanced Cardiac Ultrasound using Diverging Waves
Stanziola, A., Toulemonde, M., Papadopoulou, V., Corbett, R., Duncan, N., Grisan, E. and Tang, M-X. (2019). Sparse Image Reconstruction for Contrast Enhanced Cardiac Ultrasound using Diverging Waves. IEEE International Ultrasonics Symposium 2019. Glasgow 09 2009 - 06 Oct 2019 Institute of Electrical and Electronics Engineers (IEEE).
Super resolution ultrasound image filtering with machine learning to reduce the localization error
Harput, S., Fong, L.H., Stanziola, A., Zhang, G., Toulemonde, M., Zhou, J., Christensen-Jeffries, K., Brown, J., Eckersley, R., Grisan, E., Dunsby, C. and Tang, M. (2019). Super resolution ultrasound image filtering with machine learning to reduce the localization error. IEEE International Ultrasonics Symposium 2019. Glasgow 09 2009 - 06 Oct 2019 Institute of Electrical and Electronics Engineers (IEEE).
Temporal Convolution Networks for Real-Time Abdominal Fetal Aorta Analysis with Ultrasound
Savioli, N., Visentin, S., Cosmi, E., Grisan, E., Lamata, P. and Montana, G. (2018). Temporal Convolution Networks for Real-Time Abdominal Fetal Aorta Analysis with Ultrasound. Artificial Neural Networks and Machine Learning – ICANN 2018. Rhodes, Greece 04 - 07 Oct 2018 Springer. https://doi.org/10.1007/978-3-030-01421-6_15
Quantitative imaging by pixel-based contrast-enhanced ultrasound reveals a linear relationship between synovial vascular perfusion and the recruitment of pathogenic IL-17A-F+IL-23+ CD161+ CD4+ T helper cells in psoriatic arthritis joints
Fiocco, U, Stramare, R, Martini, V, Coran, A, Caso, F, Costa, L, Felicetti, M, Rizzo, G, Tonietto, M, Scanu, A, Oliviero, F, Raffeiner, B, Vezzù, M, Lunardi, F, Scarpa, R, Sacerdoti, D, Rubaltelli, L, Punzi, L, Doria, A and Grisan, E (2017). Quantitative imaging by pixel-based contrast-enhanced ultrasound reveals a linear relationship between synovial vascular perfusion and the recruitment of pathogenic IL-17A-F+IL-23+ CD161+ CD4+ T helper cells in psoriatic arthritis joints. Clinical Rheumatology. 36 (2), pp. 391-399. https://doi.org/10.1007/s10067-016-3500-x
Boosting the Battery Life of Wearables for Health Monitoring Through the Compression of Biosignals
Hooshmand, M, Zordan, D, Del Testa, D, Grisan, E and Rossi, M (2017). Boosting the Battery Life of Wearables for Health Monitoring Through the Compression of Biosignals. IEEE Internet of Things Journal. 4, pp. 1647-1662. https://doi.org/10.1109/JIOT.2017.2689164
Detection of a slow-flow component in contrast-enhanced ultrasound of the synovia for the differential diagnosis of arthritis
Rizzo, G, Tonietto, M, Castellaro, M, Raffeiner, B, Coran, A, Fiocco, U, Stramare, R and Grisan, E (2017). Detection of a slow-flow component in contrast-enhanced ultrasound of the synovia for the differential diagnosis of arthritis. SPIE Medical Imaging. Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2250818
Improving the quantification of contrast enhanced ultrasound using a Bayesian approach
Rizzo, G, Tonietto, M, Castellaro, M, Raffeiner, B, Coran, A, Fiocco, U, Stramare, R and Grisan, E (2017). Improving the quantification of contrast enhanced ultrasound using a Bayesian approach. SPIE Medical Imaging. Orlando, FL , USA 16 2016 - 11 Feb 2017 SPIE. https://doi.org/10.1117/12.2250195
Superpixel-based classification of gastric chromoendoscopy images
Boschetto, D and Grisan, E (2017). Superpixel-based classification of gastric chromoendoscopy images. SPIE Medical Imaging. Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2254187
Boosted learned kernels for data-driven vesselness measure
Grisan, E (2017). Boosted learned kernels for data-driven vesselness measure. Proceedings Volume 10137, Medical Imaging 2017: Biomedical Applications in Molecular, Structural, and Functional Imaging; 101370Z (2017). Orlando, FL, USA 11 - 16 Feb 2017 SPIE. https://doi.org/10.1117/12.2250370
Cortical Thickness variability in Multiple Sclerosis: The role of lesion segmentation and filling
Palombit, A, Castellaro, M, Calabrese, M, Romualdi, C, Pizzini, FB, Montemezzi, S, Grisan, E and Bertoldo, A (2017). Cortical Thickness variability in Multiple Sclerosis: The role of lesion segmentation and filling. 2017 IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017). Melbourne, VIC, Australia 18 - 21 Apr 2017 pp. 792-795 https://doi.org/10.1109/ISBI.2017.7950637
From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis
Grisan, E, Rizzo, G, Tonietto, M, Coran, A, Raffeiner, B, Scanu, A, Martini, V, Stramare, R and Fiocco, U (2017). From macro to nano: Linking quantitative CEUS perfusion parameters to CD4+ T cells subtypes in spondyloarthtitis. 2017 IEEE 14th International Symposium on Biomedical Imaging (ISBI 2017). Melbourne, VIC, Australia 17 - 21 Apr 2017 Institute of Electrical and Electronics Engineers (IEEE). pp. 899-902 https://doi.org/10.1109/ISBI.2017.7950661
Grade and location of power doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α
Raffeiner, B, Grisan, E, Botsios, C, Stramare, R, Rizzo, G, Bernardi, L, Punzi, L, Ometto, F and Doria, A (2017). Grade and location of power doppler are predictive of damage progression in rheumatoid arthritis patients in clinical remission by anti-tumour necrosis factor α. Rheumatology (United Kingdom). 56, pp. 1320-1325. https://doi.org/10.1093/rheumatology/kex084
Bayesian Quantification of Contrast-Enhanced Ultrasound Images with Adaptive Inclusion of an Irreversible Component
Rizzo, G, Tonietto, M, Castellaro, M, Raffeiner, B, Coran, A, Fiocco, U, Stramare, R and Grisan, E (2017). Bayesian Quantification of Contrast-Enhanced Ultrasound Images with Adaptive Inclusion of an Irreversible Component. IEEE Transactions on Medical Imaging. 36, pp. 1027-1036. https://doi.org/10.1109/TMI.2016.2637698
Tcf7l2 plays pleiotropic roles in the control of glucose homeostasis, pancreas morphology, vascularization and regeneration
Facchinello, N, Tarifeño-Saldivia, E, Grisan, E, Schiavone, M, Peron, M, Mongera, A, Ek, O, Schmitner, N, Meyer, D, Peers, B, Tiso, N and Argenton, F (2017). Tcf7l2 plays pleiotropic roles in the control of glucose homeostasis, pancreas morphology, vascularization and regeneration. Scientific Reports. 7. https://doi.org/10.1038/s41598-017-09867-x
Growth abnormalities of fetuses and infants
Cosmi, E, Grisan, E, Fanos, V, Rizzo, G, Sivanandam, S and Visentin, S (2017). Growth abnormalities of fetuses and infants. BioMed Research International. 2017. https://doi.org/https://www.doi.org/10.1155/2017/3191308
A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness
Visentin, S, Londero, AP, Camerin, M, Grisan, E and Cosmi, E (2017). A possible new approach in the prediction of late gestational hypertension: The role of the fetal aortic intima-media thickness. Medicine (United States). 96. https://doi.org/https://www.doi.org/10.1097/MD.0000000000005515
Automatic classification of small bowel mucosa alterations in celiac disease for confocal laser endomicroscopy
Boschetto, D, Di Claudio, G, Mirzaei, H, Leong, R and Grisan, E (2016). Automatic classification of small bowel mucosa alterations in celiac disease for confocal laser endomicroscopy. Medical Imaging 2016: Biomedical Applications in Molecular, Structural, and Functional Imaging. San Diego, United States 27 Feb - 03 Mar 2016 SPIE. https://doi.org/10.1117/12.2217183
Automatic classification of endoscopic images for premalignant conditions of the esophagus
Boschetto, D, Gambaretto, G and Grisan, E (2016). Automatic classification of endoscopic images for premalignant conditions of the esophagus. Medical Imaging 2016: Biomedical Applications in Molecular, Structural, and Functional Imaging. San Diego, United States 27 Feb - 03 Mar 2016 https://doi.org/10.1117/12.2216826
Superpixel-based automatic segmentation of villi in confocal endomicroscopy
Boschetto, D, Mirzaei, H, Leong, RWL and Grisan, E (2016). Superpixel-based automatic segmentation of villi in confocal endomicroscopy. 2016 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI). Las Vegas, NV, USA 24 - 27 Feb 2016 pp. 168-171 https://doi.org/10.1109/BHI.2016.7455861
Quantification of kidneys from 3D ultrasound in pediatric hydronephrosis
Cerrolaza, J.J., Grisan, E., Safdar, N., Myers, E., Jago, J., Peters, C.A. and Linguraru, M.G. (2015). Quantification of kidneys from 3D ultrasound in pediatric hydronephrosis. Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/embc.2015.7318324