Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy

Robles-Medranda, Carlos; Oleas, Roberto; Sanchez-Carriel, Maria; Olmos, Jorge; Alcívar-Vásquez, Juan; Puga-Tejada, Miguel; Baquerizo-Burgos, Jorge; Icaza, Ivanna; Pitanga-Lukashok, Hannah

doi:10.1016/j.gie.2020.07.025

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…In addition, our CNN demonstrated high performance standards, with a sensitivity and specificity of 99 %, an accuracy of 99 %, and an AUROC of 1.00. Robles-Medranda et al 8 recently evaluated use of neovasculature for identification of neoplastic bile duct lesions. Irregular TVs were present in 94 % of patients with malignant lesions and 37 % of patients with benign lesions.…”

Section: Discussionmentioning

confidence: 99%

“…These vessels represent the process of angiogenesis, a vital process in the progression of cancer, and can be identified by D-SOC in the superficial layers of the bile duct wall. Indeed, detection of irregular or spider vascularity on bile duct lesions during D-SOC evaluations accurately identifies biliary neoplastic lesions 8 . However, identification of TV in BS may be particularly difficult in the presence of chronic biliary tract inflammation, such as in PSC.…”

Section: Introductionmentioning

confidence: 99%

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Automatic detection of tumor vessels in indeterminate biliary strictures in digital single-operator cholangioscopy

et al. 2022

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Background and study aims Indeterminate biliary strictures pose a significative clinical challenge. Dilated, irregular, and tortuous vessels, often described as tumor vessels, are frequently reported in biliary strictures with high malignancy potential during digital single-operator cholangioscopy (D-SOC). In recent years, the development of artificial intelligence (AI) algorithms for application to endoscopic practice has been intensely studied. We aimed to develop an AI algorithm for automatic detection of tumor vessels (TVs) in D-SOC images. Patients and methods A convolutional neural network (CNN) was developed. A total of 6475 images from 85 patients who underwent D-SOC (Spyglass, Boston Scientific, Marlborough, Massachusetts, United States) were included. Each frame was evaluated for the presence of TVs. The performance of the CNN was measured by calculating the area under the curve (AUC), sensitivity, specificity, positive and negative predictive values. Results The sensitivity, specificity, positive predictive value, and negative predictive value were 99.3 %, 99.4 %, 99.6% and 98.7 %, respectively. The AUC was 1.00. Conclusions Our CNN was able to detect TVs with high accuracy. Development of AI algorithms may enhance the detection of macroscopic characteristics associated with high probability of biliary malignancy, thus optimizing the diagnostic workup of patients with indeterminate biliary strictures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Automatic detection of tumor vessels in indeterminate biliary strictures in digital single-operator cholangioscopy

et al. 2022

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“…Thus, decision of surgical management could take into consideration the endoscopist's visual opinion on an indeterminate biliary stricture. Tumor vessels, papillary projection, nodular or polypoid mass, and infiltrative lesions are highly suggestive of neoplastic/malignant biliary disease [32,33 ▪ ,34,35]. Image enhancement during cholangioscopy may increase the diagnostic sensitivity of visual impression of malignant biliary strictures [36].…”

Section: Indicationsmentioning

confidence: 99%

Cholangioscopy for biliary diseases

Becq

Soualy

Camus

2023

Current Opinion in Gastroenterology

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Purpose of reviewCholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy. Recent findingsNumerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come. SummaryCholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully. Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.

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“…Diagnostic accuracies comparison were defined through DeLong’s test for two ROC curves. 1 2 3 4 5 6 7 8 9 10 11 .…”

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confidence: 99%

A Comparative Analysis of Artificial Intelligence-based Digital Cholangioscopy and Probe-based Confocal Laser Endomicroscopy for Detecting Malignant Bile Duct Lesions: A single-centre retrospective study

Robles-Medranda,

Baquerizo-Burgos,

Puga-Tejada

et al. 2023

ESGE Days 2023

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Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy

Cited by 15 publications

References 16 publications

Automatic detection of tumor vessels in indeterminate biliary strictures in digital single-operator cholangioscopy

Automatic detection of tumor vessels in indeterminate biliary strictures in digital single-operator cholangioscopy

Cholangioscopy for biliary diseases

A Comparative Analysis of Artificial Intelligence-based Digital Cholangioscopy and Probe-based Confocal Laser Endomicroscopy for Detecting Malignant Bile Duct Lesions: A single-centre retrospective study

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