Detection of elusive polyps using a large-scale artificial intelligence system (with videos)

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

Research output: Contribution to journalArticlepeer-review


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 that 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 3611 hours of colonoscopy videos derived from 2 sources and was validated on a set comprising 1393 hours from a third unrelated source. Ground truth labeling was provided by offline gastroenterologist annotators who were able to watch the video in slow motion and pause and rewind as required. To assess applicability, stability, and user experience and to obtain some preliminary data on performance in a real-life scenario, a preliminary prospective clinical validation study was performed comprising 100 procedures. Results DEEP2 achieved a sensitivity of 97.1% at 4.6 false alarms per video for all polyps and of 88.5% and 84.9% for polyps 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 .22 polyps per sequence. In the clinical validation study, the system detected an average of .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. (Clinical trial registration number: NCT04693078.)
Original languageEnglish
Pages (from-to)1099-1109.e10
JournalGastrointestinal Endoscopy
Issue number6
StatePublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021 American Society for Gastrointestinal Endoscopy

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging


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