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Role of artificial intelligence in the diagnosis of oesophageal neoplasia:2020 an endoscopic odyssey

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World Journal of Gastroenterology 2020年第38期26卷 5784-5796页

作者： Mohamed Hussein Juana González-Bueno Puyal Peter Mountney laurence B lovat Rehan Haidry Wellcome/EPSRC Centre for Interventional and Surgical Sciences Division of Surgery and Interventional SciencesUniversity College LondonLondon W1W 7TYUnited Kingdom Wellcome/EPSRC Centre for Interventional and Surgical Sciences University College LondonLondon W1W 7TYUnited Kingdom and Odin VisionLondon W1W 7TSUnited Kingdom Odin Vision London W1W 7TSUnited Kingdom Department of GI Services University College London HospitalLondon NW12BUUnited Kingdom

The past decade has seen significant advances in endoscopic imaging and optical enhancements to aid early *** is still a treatment gap due to the underdiagnosis of lesions of the *** aided diagnosis may play an important role in the coming years in providing an adjunct to endoscopists in the early detection and diagnosis of early oesophageal cancers,therefore curative endoscopic therapy can be *** in this area of artificial intelligence is expanding and the future looks *** this review article we will review current advances in artificial intelligence in the oesophagus and future directions for development.

关键词： Artificial intelligence Oesophageal neoplasia Barrett's oesophagus Squamous dysplasia Computer aided diagnosis Deep learning

Miniature gastrointestinal endoscopy: Now and the future

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World Journal of Gastroenterology 2019年第30期25卷 4051-4060页

作者： John J McGoran Mark E McAlindon Prasad G Iyer Eric J Seibel Rehan Haidry laurence B lovat Sarmed S Sami Digestive Diseases Centre Leicester Royal InfirmaryLeicester LE1 5WWUnited Kingdom Department of Gastroenterology Royal Hallamshire HospitalSheffield S10 2JFUnited Kingdom Division of Gastroenterology and Hepatology Mayo Clinic RochesterMN 55905United States Department of Mechanical Engineering University of Washington4000 Mason StSeattleWA 98195United States Division of Surgery and Interventional Science University College LondonLondon WC1E 6BTUnited Kingdom

Since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical *** method of achieving this has been to reduce the caliber of endoscopic *** propose the collective term“Miniature GI Endoscopy”.In this Opinion Review,the innovations in this field are explored and *** progress and clinical use of the three main areas of miniature GI endoscopy(ultrathin endoscopy,wireless endoscopy and scanning fiber endoscopy)are *** opportunities presented by these technologies are set out in a clinical context,as are their current *** of the positive aspects of miniature endoscopy are clear,in that smaller devices provide access to potentially all of the alimentary canal,while conferring high patient *** must be balanced with the costs of new technologies and recognition of device specific *** on future application are also considered and the efforts being made to bring new innovations to a clinical platform are *** devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms,therapeutic intervention and *** technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.

关键词： Ultrathin endoscopy Capsule endoscopy Single fiber endoscopy

OPTICAL MEASUREMENT OF PHOTOSENSITIZER CONCENTRATION IN VIVO

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Journal of Innovative Optical Health Sciences 2011年第2期4卷 97-111页

作者： MARTIN R.AUSTWICK JOSEPHINE H.WOODHAMS VADZIM CHALAU CHARLES A.MOSSE CAROLINE ELIOT laurence lovat ALEXANDER J.MACROBERT IRVING J.BIGIO STEPHEN G.BOWN National Medical Laser Centre Charles Bell House 67-73 Riding House Street University College London London W1W 7EJUK Boston University BME44 Cummington Street BostonMA 02215USA

Most techniques for measuring tissue concentrations of drugs are invasive,time-consuming,and often require the removal of tissue or *** pharmacokinetics(OP)is a minimally invasive alternative giving an immediate *** of white light are directed at the tissue of interest using afiber optic *** light is detected by a secondfiber immediately adjacent to thefirst in the same probe(separation 1.7 mm).Using the photosensitizer disulfonated aluminium phthalocyanine(AlS_(2)Pc),OP measurements were made in phantoms and on the mouth,stomach,colon,skin,and liver of normal rats 1 and 24 h after intravenous AlS_(2)Pc ***_(2)Pc concentration was determined by calculating the area under the curve(AUC)in the spectral region around the peak drug absorption or measuring the height of the *** baseline interpolation removed the need for pre-drug,control optical *** measurements correlated well with values from alkali chemical extraction(CE)of the corresponding tissues,(R^(2)0.87=0.97).OP measurements in the mouth also correlated with CE of less accessible internal organs(R^(2)0.77-0.88).In phantoms,the lowest detectable concentration was 0.1μg/*** vivo,results were limited by the lower accuracy in the CE measurements but were almost certainly *** incidentalfinding was a 12-15nm red shifted component in the spectra observed 1 h after drug administration,suggesting partitioning of the drug in different microenvironment compartments,which could prove to be of considerable interest in future *** conclusion,OP shows promise for real-time measurement of concentrations of drugs with suitable absorption peaks.

关键词： Optical pharmacokinetics chemometrics photodynamic therapy noninvasive measurement

High resolution colonoscopy in a bowel cancer screening program improves polyp detection

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World Journal of Gastroenterology 2011年第38期17卷 4308-4313页

作者： Matthew R Banks Rehan Haidry M Adil Butt Lisa Whitley Judith Stein Louise Langmead Stuart L Bloom Austin O' Bichere Sara McCartney Kalpesh Basherdas Manuel Rodriguez-Justo laurence B lovat Department of Gastrointestinal Services University College London Hospitals NHS Foundation Trust Department of Histopathology University College London Hospitals NHS Foundation Trust

AIM:To compare high resolution colonoscopy(Olympus Lucera) with a megapixel high resolution system(Pentax HiLine) as an in-service ***:Polyp detection rates and measures of performance were collected for 269 colonoscopy *** colonoscopists conducted the study over a three month period,as part of the United Kingdom bowel cancer screening ***:There were no differences in procedure duration(χ2 P = 0.98),caecal intubation rates(χ2 P = 0.67),or depth of sedation(χ2 P = 0.64).Mild discomfort was more common in the Pentax group(χ2 P = 0.036).Adenoma detection rate was significantly higher in the Pentax group(χ2 test for trend P = 0.01).Most of the extra polyps detected were flat or sessile ***:Megapixel definition colonoscopes improve adenoma detection without compromising other measures of endoscope *** polyp detection rates may improve future outcomes in bowel cancer screening programs.

关键词：高分辨率检查程序筛查肠癌检测肉大肠百万像素

Risk of lymph node metastases in patients with T1b oesophageal adenocarcinoma: A retrospective single centre experience

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World Journal of Gastroenterology 2018年第41期24卷 4698-4707页

作者： David Graham Nejc Sever Cormac Magee William Waddingham Matthew Banks Rami Sweis Hannah Al-Yousuf Miriam Mitchison Durayd Alzoubaidi Manuel Rodriguez-Justo laurence lovat Marco Novelli Marnix Jansen Rehan Haidry GI Services University College London Hospital Division of Surgery and Science University College London Gastroenterology Department University Medical Center Ljubljana Department of Metabolism and Experimental Therapeutics University College London

AIM To assess clinical outcomes for submucosal (T1b) oesophageal adenocarcinoma (OAC) patients managed with either surgery or endoscopic eradication *** Patients found to have T1b OAC following endoscopic resection between January 2008 to February 2016 at University College London Hospital were retrospectively analysed. Patients were split into low-risk and high-risk groups according to established histopathological criteria and were then further categorised according to whether they underwent surgical resection or conservative management. Study outcomes include the presence of lymphnode metastases, disease-specific mortality and overall survival. RESULTS A total of 60 patients were included; 22 patients were surgically managed (1 low-risk and 21 high-risk patients) whilst 38 patients were treated conservatively (12 low-risk and 26 high-risk). Overall, lymph node metastases (LNM) were detected in 10 patients (17%); six of these patients had undergone conservative management and LNM were detected at a median of 4 mo after endoscopic mucosal resection (EMR). All LNM occurred in patients with highrisk lesions and this represented 21% of the total high-risk lesions. Importantly, there was no statistically significant difference in tumor-related deaths between those treated surgically or conservatively (P = 0.636) and disease-specific survival time was also comparable between the two treatment strategies (P = 0.376).CONCLUSION T1b tumours without histopathological high-risk markers of LNM can be treated endoscopically with good outcomes. In selected patients, endoscopic therapy may be appropriate for high-risk lesions.

关键词： Oesophageal adenocarcinoma Submucosal invasion T1b Lymph node metastasis Risk prediction Endoscopy

Squamous cell carcinoma after radiofrequency ablation for Barrett's dysplasia

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World Journal of Gastroenterology 2014年第15期20卷 4453-4456页

作者： Sebastian S Zeki Rehan Haidry Manuel Justo-Rodriguez laurence B lovat Nicholas A Wright Stuart A McDonald Centre for Tumour Biology Bart’s Cancer InstituteLondon EC1M 6BQUnited Kingdom Research Department of General Surgery University College LondonLondon WC1E 6BTUnited Kingdom Department of Pathology University College LondonLondon WC1E 6BTUnited Kingdom

Barrett’s oesophagus(BO)is a usually indolent condition that occasionally requires endoscopic *** ablation(RFA)is an effective endoscopic treatment for high grade dysplasia(HGD)and intramucosal cancer in *** has a good efficacy,durability and safety profile although complications can *** we describe a case of RFA in a patient with high grade *** the response to treatment was initially very good with the development of neosquamous epithelium,the patient very rapidly developed a squamous cell cancer of the oesophagus confirmed on radiology,histology and *** sequencing confirmed that the original HGD and the squamous cell cancer(SCC)were derived from separate clonal *** report highlights the fact that SCC of the oesophagus has been noted after endoscopic ablation for BO previously and suggest that ablation of BO may encourage the clonal expansion of cells carrying carcinogenic mutations once a dominant clonal population has been eradicated.

关键词： Squamous carcinoma oesophagus Barrett’s oesophagus

Radiofrequency ablation for early oesophageal squamous neoplasia:Outcomes form United Kingdom registry

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World Journal of Gastroenterology 2013年第36期19卷 6011-6019页

作者： Rehan J Haidry Mohammed A Butt Jason Dunn Matthew Banks Abhinav Gupta Howard Smart Pradeep Bhandari Lesley Ann Smith Robert Willert Grant Fullarton Morris John Massimo Di Pietro Ian Penman Marco Novelli laurence B lovat Department of Surgery and Interventional Science National Medical Laser Centre UCL Department Gastroenterology University College Hospital NHS Foundation Trust Department Gastroenterology Guy’s and St Thomas’ Hospitals NHS Trust Institute for Medical Informatics Oslo University Hospital Department Gastroenterology Royal Liverpool University Hospital Merseyside Department Gastroenterology Princess Alexandra Hospital Cosham Department Gastroenterology Bradford Royal Infirmary Bradford Department Gastroenterology Central Manchester University Hospital Department Gastroenterology Glasgow Royal Infirmary Department Gastroenterology Addenbrooke’s Hospital Royal Infirmary Edinburgh

AIM:To report outcomes on patients undergoing radiofrequency ablation(RFA)for early oesophageal squamous neoplasia from a National ***:A Prospective cohort study from 8 tertiary referral centres in the United *** with squamous high grade dysplasia(HGD)and early squamous cell carcinoma(ESCC)confined to the mucosa were *** lesions were removed by endoscopic mucosal resection(EMR)before *** initial RFA treatment,patients were followed up *** flat dysplasia was treated with RFA until complete reversal dysplasia(CR-D)was achieved or progression to invasive Squamous cell cancer defined as infiltration into the submucosa layer or *** main outcome measures were CR-D at 12 mo from start of treatment,long term durability,progression to cancer and adverse ***:Twenty patients with squamous HGD/ESCC completed treatment *** patients(25%)had EMR before starting RFA ***-D was 50%at12 mo with a median of 1 RFA treatment,mean 1.5(range 1-3).Two further patients achieved CR-D with repeat RFA after this *** per cent with CR-D remain dysplasia free at latest biopsy,with median follow up 24 mo(IQR 17-54).Six of 20 patients(30%)progressed to invasive cancer at 1 *** patients(20%)required endoscopic dilatations for symptomatic structuring after *** of these patients have required serial dilatations thereafter for symptomatic dysphagia with a median of 4 dilatations per *** other 2 patients required only a single dilatation to achieve an adequate symptomatic *** patient developed cancer during follow up after end of treatment ***:The role of RFA in these patients re-mains *** our series 50%patients responded at12 *** figures are lower than limited published data.

关键词： Squamous neoplasia Oesophageal cancer Endoscopic mucosal resection High-grade dysplasia Radiofrequency ablation