The odds of getting colorectal cancer in America are 1 in 25 for women and 1 in 23 for men. Polyps, which are precursors to cancer, can be found and removed with colonoscopies — 15 million of which are performed in the U.S. annually. Colonoscopies are also critical to the diagnosis of Crohn’s disease, ulcerative colitis, and other colon and rectal diseases.
Cross-campus collaborations such as these were exactly the hope when UT, a longtime research powerhouse especially strong in both engineering and computer science, founded Dell Medical School a decade ago.
About 30% of all polyps are precancerous growths called adenomas, but the detection rate of adenomas varies from 7-60%. This difference in adenoma detection may be due to endoscopist technique, suboptimal colon clearing for the procedure, or tricky polyp location in the colon that some endoscopists may miss. It is also important that the whole adenoma is removed as any remaining adenoma tissue may grow into cancerous tumor.
Three professors at UT in different disciplines have come together in hopes of drastically improving the hunt for adenomas and other colorectal disease: one a surgeon at Dell Med, one in mechanical engineering, and one in electrical engineering. And they’re deploying artificial intelligence in the hunt.
Joga Ivatury, associate professor and chief of colorectal surgery at UT’s Dell Medical School, is partnering with Farshid Alambeigi, an assistant professor of mechanical engineering, and Sandeep Chinchali, an assistant professor of electrical and computer engineering, on one project, and Radu Marculescu, a professor of electrical and computer engineering, on another. They hope AI will help doctors detect polyps they can’t find even with the best current technology. “Farshid is the brains behind one operation. Radu is the brains behind the other operation. I’m merely the colorectal surgeon,” Ivatury demures. Alambeigi came to UT in 2019 from Johns Hopkins and Marculescu in 2020 from Carnegie Mellon. Ivatury trained in San Antonio and came to UT in 2021 after stints at Minnesota and Dartmouth.
Cross-campus collaborations such as these were exactly the hope when UT, a longtime research powerhouse especially strong in both engineering and computer science, founded Dell Medical School a decade ago.
“Some AI for adenoma detection already exists,” Ivatury says, but it doesn’t appear to have moved the needle in terms of identifying the smaller polyps. It identifies the adenomas that most endoscopists can already see. What we’re trying to do is to get the smaller ones and the ones that are very subtle by looking at each colonoscopy image pixel by pixel. Our AI algorithm is learning exactly where the adenoma is and drawing a very precise line around it. This ensures the adenoma is identified and is completely removed. The pixel-based segmentation that Radu is an expert in really can allow that,” Ivatury says. Ph.D. student Mostafijur Rahman assists Marculescu in this image segmentation.
Seeing a polyp with an endoscope is currently the only way of evaluating one, and the endoscopist sees only a limited front view. But what if an endoscopist could also “feel” the colon lining or potential polyp before deciding whether to remove it? Ivatury and mechanical engineer Alambeigi are developing a device that will allow doctors to do just that with an inflatable tactile sensor.
In the near future, once an endoscopist sees a polyp with the camera, they will move a donut-shaped balloon, two inches in diameter, that fits like a collar around the camera, over the suspicious area. Then, with a joystick device, they will inflate the donut, either with air or liquid, and the donut, partially covered with a sensor, will tell the endoscopist whether the area is hard or soft, rough or smooth. (In general, hard or rough is bad.) The tactile sensor acts as a virtual fingertip on any surface. The sensor in turn generates its own image, and so its full name is vision-based tactile sensor.
Ivatury and Alambeigi have received a grant from UT’s IC2 Institute to develop the tactile sensor and hope that within five years it could be in clinical trials. Meanwhile, Ivatury and Marculescu have received a Texas Catalyst Grant from UT and Dell Med to pursue their research on the use of AI in colonoscopy.
Read the full article: AI in the GI