{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:24:13Z","timestamp":1776705853352,"version":"3.51.2"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"crossref","award":["1005809"],"award-info":[{"award-number":["1005809"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["2021.06503.BD,PTDC\/EEI-EEE\/5557\/2020"],"award-info":[{"award-number":["2021.06503.BD,PTDC\/EEI-EEE\/5557\/2020"]}]},{"DOI":"10.13039\/100031478","name":"NextGenerationEU","doi-asserted-by":"crossref","award":["2024.07584.IACDC\/2024"],"award-info":[{"award-number":["2024.07584.IACDC\/2024"]}],"id":[{"id":"10.13039\/100031478","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018693","name":"HORIZON EUROPE Framework Programme","doi-asserted-by":"crossref","award":["101095359"],"award-info":[{"award-number":["101095359"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) classification correlates with histological assessment of gastric intestinal metaplasia and enables stratification of gastric cancer risk. We developed and evaluated an artificial intelligence (AI) approach for EGGIM estimation.<\/jats:p>\n                  <jats:p>Two datasets (A and B) with 1280 narrow-band imaging images were used for per-image analysis. Still images with manually selected patches of 224 \u00d7 224 pixels, annotated by experts, were used. Dataset A was retrospectively collected from clinical routine; Dataset B (used for per-patient analysis) was prospectively collected and included 65 fully documented patients. To mimic clinical practice, a deep neural network classified image patches into three EGGIM classes (0, 1, 2) and calculated the total per-patient EGGIM score (0\u201310).<\/jats:p>\n                  <jats:p>On per-image analysis, an accuracy of 87% (95%CI 71%\u2013100%) was obtained. Per-patient EGGIM estimation had an average error of 1.15 (out of 10) and showed 88% (95%CI 80%\u201396%) accurate clinical decisions for surveillance (EGGIM \u22655), with 85% (95%CI 75%\u201394%) specificity, no false negatives, and positive and negative predictive values of 62% (95%CI 32%\u201392%) and 100% (95%CI 100%\u2013100%), respectively.<\/jats:p>\n                  <jats:p>EGGIM was estimated with high accuracy using AI tools in endoscopic image analyses. Automated assessment of EGGIM may provide a greener strategy for gastric cancer risk stratification, prospective studies, and interventional trials.<\/jats:p>","DOI":"10.1055\/a-2657-9906","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T23:57:28Z","timestamp":1752796648000},"page":"1254-1260","source":"Crossref","is-referenced-by-count":7,"title":["Artificial intelligence for endoscopic grading of gastric intestinal metaplasia: advancing risk stratification for gastric cancer"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9273-966X","authenticated-orcid":false,"given":"Eduarda","family":"Almeida","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"}]},{"given":"Miguel Lopes","family":"Martins","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Universidade do Porto (FCUP), Porto, Portugal"}]},{"given":"David","family":"Marques","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Universidade do Porto (FCUP), Porto, Portugal"}]},{"given":"Rose","family":"Delas","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"},{"name":"D\u00e9partement STIC, \u00c9cole Nationale Sup\u00e9rieure de Techniques Avanc\u00e9es Bretagne, Brest, France"}]},{"given":"Tatiana","family":"Almeida","sequence":"additional","affiliation":[{"name":"Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI\u2010IPOP)\/CI\u2010IPOP@RISE (Health Research Group), Portuguese Institute of Oncology of Porto (IPO Porto)\/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal"}]},{"given":"J\u00e9ssica","family":"Chaves","sequence":"additional","affiliation":[{"name":"Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI\u2010IPOP)\/CI\u2010IPOP@RISE (Health Research Group), Portuguese Institute of Oncology of Porto (IPO Porto)\/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal"},{"name":"Gastroenterology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal"}]},{"given":"Diogo","family":"Lib\u00e2nio","sequence":"additional","affiliation":[{"name":"Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI\u2010IPOP)\/CI\u2010IPOP@RISE (Health Research Group), Portuguese Institute of Oncology of Porto (IPO Porto)\/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal"},{"name":"Gastroenterology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal"}]},{"given":"Francesco","family":"Renna","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Universidade do Porto (FCUP), Porto, Portugal"}]},{"given":"Miguel Tavares","family":"Coimbra","sequence":"additional","affiliation":[{"name":"Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ci\u00eancia \u2013 INESC TEC, Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Universidade do Porto (FCUP), Porto, Portugal"}]},{"given":"M\u00e1rio","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[{"name":"Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI\u2010IPOP)\/CI\u2010IPOP@RISE (Health Research Group), Portuguese Institute of Oncology of Porto (IPO Porto)\/Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal"},{"name":"Gastroenterology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal"}]}],"member":"194","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"F Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","first-page":"6735","article-title":"Human gastric carcinogenesis: a multistep and multifactorial process \u2013 first American Cancer Society award lecture on cancer epidemiology and prevention","volume":"52","author":"P Correa","year":"1992","journal-title":"Cancer Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1055\/a-0859-1883","article-title":"Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019","volume":"51","author":"P Pimentel-Nunes","year":"2019","journal-title":"Endoscopy"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/0734242X17739968","article-title":"Costs associated with the management of waste from healthcare facilities: an analysis at national and site level","volume":"36","author":"M Vaccari","year":"2018","journal-title":"Waste Manag Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/ajcp\/aqab021","article-title":"Life cycle greenhouse gas emissions of gastrointestinal biopsies in a surgical pathology laboratory","volume":"156","author":"IO Gordon","year":"2021","journal-title":"Am J Clin Pathol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1055\/a-0808-3186","article-title":"Endoscopic grading of gastric intestinal metaplasia (EGGIM): a multicenter validation study","volume":"51","author":"G Esposito","year":"2019","journal-title":"Endoscopy"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/00365521.2020.1849385","article-title":"Gastric intestinal metaplasia assessment between linked color imaging based on endoscopy and pathology","volume":"56","author":"G Zhang","year":"2021","journal-title":"Scand J Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1018248","article-title":"The role of the endoscopic grading of gastric intestinal metaplasia in assessing gastric cancer risk: a systematic review and meta-analysis","volume":"12","author":"S Fang","year":"2022","journal-title":"Front Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1111\/jgh.16493","article-title":"Carbon footprint and cost reduction by endoscopic grading of gastric intestinal metaplasia using narrow-band imaging","volume":"39","author":"J-H Cho","year":"2024","journal-title":"J Gastroenterol Hepatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1136\/gutjnl-2024-332820","article-title":"QUAIDE \u2013 quality assessment of AI preclinical studies in diagnostic endoscopy","volume":"74","author":"G Antonelli","year":"2024","journal-title":"Gut"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1055\/a-1205-0570","article-title":"Image-enhanced endoscopy for gastric preneoplastic conditions and neoplastic lesions: a systematic review and meta-analysis","volume":"52","author":"M Rodr\u00edguez-Carrasco","year":"2020","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1080\/00365521.2019.1684555","article-title":"Reliability and accuracy of blue light imaging for staging of intestinal metaplasia in the stomach","volume":"54","author":"R Castro","year":"2019","journal-title":"Scand J Gastroenterol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1055\/s-0042-108435","article-title":"A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions","volume":"48","author":"P Pimentel-Nunes","year":"2016","journal-title":"Endoscopy"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0303421","article-title":"Accuracy of artificial intelligence-assisted endoscopy in the diagnosis of gastric intestinal metaplasia: a systematic review and meta-analysis","volume":"19","author":"N Li","year":"2024","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1053\/j.gastro.2020.07.049","article-title":"Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older","volume":"159","author":"SC Shah","year":"2020","journal-title":"Gastroenterology"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1055\/a-1950-5694","article-title":"Expected value of artificial intelligence in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement","volume":"54","author":"H Messmann","year":"2022","journal-title":"Endoscopy"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/MEG.0000000000002680","article-title":"Combined gastric and colorectal cancer endoscopic screening may be cost-effective in Europe with the implementation of artificial intelligence: an economic evaluation","volume":"36","author":"D Lib\u00e2nio","year":"2024","journal-title":"Eur J Gastroenterol Hepatol"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2657-9906.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T23:31:04Z","timestamp":1761694264000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2657-9906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":17,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,10,28]]},"published-print":{"date-parts":[[2025,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2657-9906","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7,17]]},"published":{"date-parts":[[2025,7,17]]}}}