A frame reduction system based on a color structural similarity (CSS) method and Bayer images analysis for capsule endoscopy
Publication date: Available online 29 December 2018Source: Artificial Intelligence in MedicineAuthor(s): Qasim Al-sheban, Prashan Premaratne, Darryl J. McAndrew, Peter J. Vial, Shehan AbeyAbstractA capsule endoscopy examination of the human small bowel generates a large number of images that have high similarity. In order to reduce the time it takes to review the high similarity images, clinicians will increase the playback speed, typically to 15 frames per second . Associated with this behaviour is an increased probability of overlooking an image that may contain an abnormality. An alternative option to increasing the playback speed is the application of abnormality detection systems to detect abnormalities such as ulcers, tumors, polyps and bleeding. However, applying all of these detection systems requires significant computing time and still produces numerous images with high similarity depending on the specificity of the utilized detection systems. An interesting approach to reduce viewing time is the application of a frame reduction system that reduces the number of images by omitting those with a high similarity of information. The advantage of such a system is that the specialist only needs to review a single image that technically represents a series of images with high similarity. This reduces the total number of images that a specialist must review and importantly, images containing any abnormality are not removed from the review, but simply reduced in number. T...
Bleeding is a common and serious complication of endoscopic mucosal resection (EMR) of duodenal polyps occurring in 0-33% of cases. Early identification of risk factors for post-procedural bleeding (PPB) may aid in implementation of risk-modification techniques and post-procedural management (e.g. admission for observation). A prediction scoring system will be more helpful in predicting PPB in patients with more than one risk factor Aim: To evaluate risk factors for PPB after EMR of sporadic duodenal non-ampullary polyps
Peutz Jeghers Syndrome (PJS) is a dominant autosomal hereditary disease, characterized by the finding of hamartomatous polyps, particularly in the small bowel (SB) and mucopigmented lesions. Surveillance and management of SB polyps is recommended, in order to prevent any complications (invagination, bleeding and malignity). Any polyp over 1 cm must be resected. The capsule endoscopy , together with the enterotomography and enteroscopy enable the early discovery and resection of polyps, thus avoiding surgery.
Bleeding is the most common complication associated with polypectomy of large pedunculated colonic polyp. Although several techniques have been developed to minimize bleeding, none of these methods has become the gold standard. To prevent post-polypectomy bleeding effectively, we developed and attempted a new endoscopic technique for removal of large long-stalked pedunculated colonic polyps using band ligations.
The incidence of duodenal polyps is approximately 1% in retrospective studies and up to 4.6% in one prospective study. Resection of suspected adenomas is recommended as they have a high incidence of development of high grade dysplasia or cancer. Endoscopic resection is associated with high rates of bleeding and perforation. Technical complexity, including involvement of the major papilla need for forward and side- viewing endoscopes, and angulation of the folds makes complete resection challenging.
With more colorectal cancer screening&large polyp removal, delayed post-polypectomy ulcer bleeds (PPUB) are increasing. Risk factors are right colon, sessile configuration, EMR removal, bleeding during polypectomy,&resumption of anti-coagulants&/or dual anti-platelet drugs. Prophylactic clip closure of PPU ’s is reported to be safe but does not reduce delayed PPUB nor is it cost effective. In our studies of patients hospitalized with delayed PPUB, all had ulcers, most with stigmata&arterial blood flow detected by Doppler endoscopic probe (DEP).
Due to the increase in lifestyle diseases and the aging of the population, the number of patients who need oral antithrombotic drugs increased. Therefore, the cases of endoscopy with antithrombotic agents, such as warfarin and direct oral anti-coagulants (DOAC) are increasing. Previously, many gastroenterologist using heparin bridge methods for patients with anticoagulants, such as warfarin, to conduct endoscopic mucosal resection for colorectal polyps. However later, it is reported that bleeding events are increasing using heparin bridge methods.
Direct oral anticoagulants (DOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban, have become popular as equivalent to warfarin for stroke prevention in non-valvular atrial fibrillation; however, bleeding risk from DOACs, especially the difference in risks among DOACs in endoscopic treatment, has not been reported. The study aimed to evaluate delayed bleeding risk related to early resumption of DOACs and compare the bleeding risk among DOACs after endoscopic resection of colorectal polyps.
Hot snare resection (HSR) techniques, polypectomy and endoscopic mucosal resection (EMR) are the current standard of care for the removal of colorectal polyps ≥10mm. However, conventional EMR has been associated with a post-resection bleeding rate of 2.2%-7 % and polyp recurrence rate of 12.7%. To avoid the risk of electrocautery-induced damage with HSR, cold snare resection (CSR) techniques (polypectomy and cold-EMR) have recently been advocated. There are no published RCTs comparing HSR vs. CSR for polyps ≥ 10 mm.
Cold snare polypectomy (CSP) is the primary technique for resecting colorectal polyps ≤10mm. The technique is effective, efficient, and eliminates the risk of delayed bleeding and perforation. However, data regarding the safety of CSP for pedunculated polyps is sparse. We hypothesized that CSP can be safely used for the resection of small pedunculated polyps ≤10mm.
Post-polypectomy bleeding is a known complication of polyp resection. Cold snare polypectomy is associated with reduced bleeding compared to snare cautery, but the degree of tissue injury and its impact on post-polypectomy bleeding have not been elucidated. The aim of this study is to identify and quantitate the histological differences in snare cautery, cold snare polypectomy and identify polypectomy tissue injury features associated with post-polypectomy bleeding.