Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Understanding Patients’ Current Acceptability of Artificial Intelligence During Colonoscopy for Polyp Detection: A Single-Center Study","authors":"Kathryn A. Schmidt ,&nbsp;Shubham Sood ,&nbsp;Saam Dilmaghani ,&nbsp;Cadman Leggett ,&nbsp;Ross Dierkhising ,&nbsp;Mayank Goyal ,&nbsp;Barbara A. Barry ,&nbsp;Xuan Zhu ,&nbsp;Nayantara Coelho-Prabhu","doi":"10.1016/j.tige.2024.250905","DOIUrl":"10.1016/j.tige.2024.250905","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Research into potential applications of artificial intelligence (AI) in healthcare have witnessed a meteoric rise. A primary application in gastroenterological care is colonoscopy. Before AI tools become ubiquitous in healthcare, it is critical to appreciate the perspective of the potential beneficiaries, particularly patients. This study evaluated patient acceptability of AI in colonoscopy, particularly for polyp detection and diagnosis.</div></div><div><h3>METHODS</h3><div>In this cross-sectional survey study, patients undergoing outpatient colon cancer screening or surveillance colonoscopies at Mayo Clinic, Rochester, from September 2023 to February 2024 completed an electronic self-administered survey via tablet computer including questions regarding AI in colonoscopy. The primary outcome was patient perspectives on AI, and secondary outcomes included patient factors influencing their perspective. Statistical analyses were performed using Pearson's chi-square test and ordinal logistic regression.</div></div><div><h3>RESULTS</h3><div>Five hundred eight participants completed the survey. Younger age, male gender, and higher education were associated with higher AI familiarity and perceived importance, while males and those who believed in AI's positive outcomes were more comfortable with AI-assisted polyp detection.</div></div><div><h3>CONCLUSION</h3><div>This study is the first to assess patient perceptions of AI in colonoscopy. While patients generally believe AI can improve health outcomes, there is uncertainty about its current use, indicating a gap in knowledge and awareness. Key findings highlight that beliefs in AI's efficacy are linked to increased comfort with AI-assisted procedures, with significant demographic variations in perceptions, particularly across gender, age, and education. Addressing disparities through targeted education and transparent communication is crucial for fostering patient acceptance and trust in AI-assisted colonoscopy.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250905"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound-Guided Gallbladder Drainage for Acute Cholecystitis and for Expanded Indications: Technique and Outcomes","authors":"Andrea Anderloni ,&nbsp;Cecilia Binda ,&nbsp;Aurelio Mauro ,&nbsp;Stefano Mazza ,&nbsp;Carlo Fabbri ,&nbsp;Anthony Y.B. Teoh","doi":"10.1016/j.tige.2025.250912","DOIUrl":"10.1016/j.tige.2025.250912","url":null,"abstract":"<div><div>Interventional endoscopic ultrasound (EUS) is constantly evolving, thanks to its efficacy for the treatment of several clinical conditions, leading to an extension of applications and indications over the years. Among these, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has become the preferred treatment for acute cholecystitis (AC) in high surgical risk patients, thanks to the introduction of electrocautery-enhanced lumen-apposing metal stents, which allowed a higher standardization of the technique, although still improving. Despite the significant progress made over the past 10 years, there are still a number of debated issues, above all due to application of this technique in a wider variety of broadened indications, beyond AC. Indeed, increasing evidences are emerging on EUS-GBD as treatment in case of distant malignant biliary obstruction in both primary and rescue scenarios. Additionally, there is preliminary evidence on AC prevention following the implantation of fully-covered self-expandable metal stents during endoscopic retrograde cholangiopancreatography in the malignant setting and on the treatment of gallstone-related diseases in not surgically fit patients. With an emphasis on technical considerations and outcomes, this review attempts to update the current indications for EUS-GBD and provide an overview of potential new fields of application for this technique.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250912"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Distinct Breath Metabolome Signature Is Linked With Eosinophilic Esophagitis: A Proof-of-Concept Study Assessing Volatile Organic Compounds","authors":"CLAIRE A. BEVERIDGE ,&nbsp;XUEFENG ZHANG ,&nbsp;ANDREI I. IVANOV ,&nbsp;JONATHAN MARK BROWN ,&nbsp;SCOTT GABBARD ,&nbsp;FLORIAN RIEDER","doi":"10.1016/j.tige.2025.250913","DOIUrl":"10.1016/j.tige.2025.250913","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250913"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Advances Digital Pathomics for Confocal Endomicroscopy Diagnosis of Pancreatic Cysts","authors":"Ahmed Abdelbaki ,&nbsp;Ziwei Li ,&nbsp;Tai-Yu Pan ,&nbsp;Justin Lee ,&nbsp;Arpita Chowdhury ,&nbsp;Stacey Culp ,&nbsp;Bipul Gnyawali ,&nbsp;Tassiana G. Maloof ,&nbsp;Aayush B. Vishwanath ,&nbsp;Sohil Narasimha Reddy ,&nbsp;Dylan Mink ,&nbsp;Wei Chen ,&nbsp;Phil A. Hart ,&nbsp;Timothy M. Pawlik ,&nbsp;Wei-Lun Chao ,&nbsp;Somashekar G. Krishna","doi":"10.1016/j.tige.2025.250924","DOIUrl":"10.1016/j.tige.2025.250924","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy (nCLE) provides real-time optical biopsies enabling diagnosis and risk stratification of intraductal papillary mucinous neoplasms (IPMNs). However, the clinical implementation of Endoscopic ultrasound-nCLE is hindered by time-consuming image review and interobserver variability. We aimed to optimize artificial intelligence (AI) models to accurately detect diagnostic structures to address these gaps.</div></div><div><h3>METHODS</h3><div>Participants with definitive IPMN diagnoses were selected from prospective studies (2015-2023). Two observers labeled endomicroscopy images used to develop AI models to detect informative segments. Performance was assessed using area under the curve, sensitivity, specificity, and accuracy.</div></div><div><h3>RESULTS</h3><div>In 66 endomicroscopy videos of IPMNs, 291,045 frames were analyzed, with 15.5% showing papillary or vascular structures and 84.5% lacking structures. Four classification (pattern recognition) and segmentation (image division) models were tested to evaluate binary detection outcomes (papillae vs other) and ternary detection outcomes (papillae, vascularity, and nonstructure). The classification model DINOv2-ViT-G outperformed all others for the binary outcome, achieving an area under the curve of 0.942, sensitivity of 80.6%, specificity of 90.6%, and accuracy of 89.3%. For the ternary outcome, only classification models were used because labeling areas for segmentation models to detect vascularity was impractical. DINOv2-ViT-G similarly demonstrated the best performance, with sensitivities for detecting papillae, vascularity, and nonstructure of 81.7%, 82.0%, and 80.5%, respectively. The DINOv2-ViT-G model reduced nCLE video duration to 1.85 minutes of high-yield, structure-containing segments, saving 4.27 minutes (70%) per IPMN case (<em>P</em> &lt; 0.001).</div></div><div><h3>CONCLUSION</h3><div>Optimized AI models for structure identification enhance the clinical utility of nCLE by generating high-yield diagnostic segments, ensuring consistent and accurate interpretation, reducing manual effort, and enabling the development of fully autonomous systems in the future.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250924"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Cleansing Solution for High-Quality Upper Gastrointestinal Endoscopy: A Multicenter Randomized Controlled Trial","authors":"Noemi Gualandi ,&nbsp;Giulia Gibiino ,&nbsp;Giuliano Francesco Bonura ,&nbsp;Matteo Secco ,&nbsp;Paola Soriani ,&nbsp;Alessandro Cucchetti ,&nbsp;Cecilia Binda ,&nbsp;Valentina Zadro ,&nbsp;Pablo Cortegoso Valdivia ,&nbsp;Paolo Biancheri ,&nbsp;Mauro Manno ,&nbsp;Carlo Fabbri","doi":"10.1016/j.tige.2025.250928","DOIUrl":"10.1016/j.tige.2025.250928","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Esophagogastroduodenoscopy (EGD) is the gold standard examination for upper gastrointestinal (GI) disease diagnosis; however, intraluminal bubbles and mucus may reduce visibility. Mucolytic and tensioactive agents before EGD improve gastric visualization. We compared the efficacy of a novel cleansing preparation vs fasting on upper GI tract visualization during EGD.</div></div><div><h3>METHODS</h3><div>We conducted a multicenter, prospective, randomized controlled trial on consecutive adult outpatients undergoing EGD. Patients were randomized 1:1 to drink 50 mL of simethicone 150 mg, N-acetylcysteine 250 mg, and 10% acetic acid solution (Lumevis, Biofarmatec srl, Palermo, Italy) before the EGD or to fasting. The primary outcome was overall mucosal vision quality score, defined as the sum of 1-10 visual analog scale scores (0 = no visualization; 10 = perfect visualization) for each segment (esophagus, stomach, and duodenum) before washing. Secondary outcomes included adverse event rate, patient satisfaction, and EGD duration.</div></div><div><h3>RESULTS</h3><div>Patients were randomized to cleansing solution (<em>n</em> = 60) or fasting (<em>n</em> = 60). Cleansing preparation administration before EGD was associated with a higher overall mucosal vision quality score compared with fasting only (median visual analog scale score 23 [range, 21-25] vs 19 [range, 16-23], <em>P</em> = 0.001). No adverse events were reported in both groups. Patient satisfaction and EGD duration were similar between the cleansing preparation and fasting only.</div></div><div><h3>CONCLUSION</h3><div>Compared with fasting only, the administration of this novel cleansing solution was associated with improved mucosal visualization of the upper GI tract.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250928"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating Colorectal Endoscopic Submucosal Dissection: Devices and Techniques","authors":"Teppei Akimoto ,&nbsp;Naohisa Yahagi ,&nbsp;Motohiko Kato","doi":"10.1016/j.tige.2025.250932","DOIUrl":"10.1016/j.tige.2025.250932","url":null,"abstract":"<div><div>Colorectal endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic treatment that achieves a high R0 resection rate regardless of lesion size. However, its widespread adoption is limited by technical difficulties, promoting the development of various devices and techniques to support the procedure. Fundamental tools include ESD knives, transparent caps, and injection solutions. Among these, traction is especially critical for creating the mucosal flap, which is considered the most technically demanding step of ESD. Numerous traction methods and devices have been introduced, particularly for colorectal ESD. Recently, increasing attention has been paid to the use of dedicated traction devices, the pocket creation method, and buoyancy and water jet pressure under saline conditions. Nevertheless, the selection and application of these devices and techniques remain complex and underexplored. This narrative review outlines the features of available devices and techniques, discusses their appropriate selection, and provides practical tips to facilitate safe and effective colorectal ESD.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250932"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Anesthesia Does Not Affect Functional Lumen Imaging Probe Measurements in Nonadvanced Achalasia","authors":"SALIH SAMO ,&nbsp;FALAK HAMO ,&nbsp;KYLE YUQUIMPO ,&nbsp;AJAY BANSAL ,&nbsp;PETER J. KAHRILAS ,&nbsp;AMY PICHOFF","doi":"10.1016/j.tige.2025.250936","DOIUrl":"10.1016/j.tige.2025.250936","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250936"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Surveillance Patterns and Management of Helicobacter pylori in Newly Diagnosed Gastric Intestinal Metaplasia","authors":"SHIVRAM CHANDRAMOULI ,&nbsp;ANNIE L. WANG ,&nbsp;DAVID A. LEIMAN","doi":"10.1016/j.tige.2024.250904","DOIUrl":"10.1016/j.tige.2024.250904","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250904"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Hemostatic Powder Technologies for Management of Gastrointestinal Bleeding: Challenges and Solutions","authors":"Kiandokht Bashiri ,&nbsp;Alireza Meighani ,&nbsp;Mark C. Mattar ,&nbsp;Reezwana Chowdhury ,&nbsp;Sadegh Poozesh","doi":"10.1016/j.tige.2025.250940","DOIUrl":"10.1016/j.tige.2025.250940","url":null,"abstract":"<div><div>Hemostatic powder spray (HPS) such as Hemospray or EndoClot is used for endoscopic treatment of both upper and lower Gastrointestinal (GI) bleeding, demonstrating high immediate hemostasis rates across various types, including nonvariceal, variceal, and tumor-related hemorrhages. Compared to conventional therapies, HPS exhibits significantly higher odds of primary hemostasis and is particularly effective in challenging cases such as diffuse hemorrhage, refractory gastric variceal bleeding, and malignant bleeding where there is no single focal area suitable for cauterization or clipping. Despite its clinical effectiveness, several challenges impede its broader application, including moisture-induced powder clumping, limited adhesion in the humid GI environment, transient hemostatic effects, and frequent catheter clogging. Additionally, existing CO₂-propelled delivery systems with fixed mixing ratios restrict adaptability across diverse clinical scenarios. This review systematically examines these limitations and proposes comprehensive solutions to enhance HPS's performance. Key advancements discussed include optimized powder formulations, suspension-based delivery systems, and the utilization of alternative propellant gases to mitigate clumping and improve adhesion. Furthermore, innovative delivery mechanisms such as hybrid mixing systems, adjustable catheter tips, and the integration of real-time feedback mechanisms are explored to increase precision and efficacy. By addressing these technical and operational challenges, this review outlines a strategic pathway for optimizing HPS’s functionality and expanding its clinical utility in managing GI bleeding, aiming to improve patient outcomes and procedural reliability.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250940"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience","authors":"Mariano González-Haba Ruiz ,&nbsp;Pedro Pereira ,&nbsp;Jessica Widmer ,&nbsp;Tiago Ribeiro ,&nbsp;Belén Agudo Castillo ,&nbsp;Filipe Vilas-Boas ,&nbsp;João Ferreira ,&nbsp;Miguel Mascarenhas Saraiva ,&nbsp;Guilherme Macedo","doi":"10.1016/j.tige.2024.250902","DOIUrl":"10.1016/j.tige.2024.250902","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250902"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}