{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:45:22Z","timestamp":1790786722950,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP23K09537"],"award-info":[{"award-number":["JP23K09537"]}]},{"name":"the Takeda Science Foundation, and The Japanese Foundation for Research and Promotion of Endoscopy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Endoscopic remission is a key therapeutic goal in ulcerative colitis (UC); however, conventional indices focus on peak severity without accounting for the spatial extent of inflammation. We developed a deep learning-based score, Quantitative Ulcerative Colitis Assessment using Deep Learning (QUAD), and evaluated whether incorporating inflammatory extent improves relapse prediction in patients with UC in clinical remission. To our knowledge, no studies have examined whether artificial intelligence (AI)-derived assessment of inflammatory extent predicts clinical relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study evaluated relapse prediction over 24\u2009months in patients with UC in clinical remission. The QUAD model assigns a score of 0-3 to each image quadrant, yielding a total score of 0-12. The model was trained on 84\u200a743 images from 998 patients with UC across three centers. Still image-based validation and automated full-length video analysis were conducted to assess the impact of inflammatory extent on relapse prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinical relapse occurred in 19.4% of patients with QUAD\u2009\u2265\u20094 compared with 5.2% of those with QUAD\u2009&amp;lt;\u20094 (P\u2009=\u2009.01), with an area under the curve (AUC) of 0.67 (95% confidence interval [CI]: 0.57-0.76). Notably, automated video-based analysis showed that distal inflammatory burden yielded the highest predictive performance, with analysis of the distal 10% segment achieving an AUC of 0.73 (95% CI: 0.62-0.85), compared with whole-colon assessment (AUC, 0.62; 95% CI: 0.48-0.76) and still image-based evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AI-augmented assessment integrating inflammatory severity and extent may provide complementary prognostic information beyond severity-based evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag115","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:45:41Z","timestamp":1784202341000},"source":"Crossref","is-referenced-by-count":1,"title":["AI-based quantification of inflammatory extent for relapse prediction in ulcerative colitis: a prospective cohort study"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-5959","authenticated-orcid":false,"given":"Yasuharu","family":"Maeda","sequence":"first","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ei","family":"Kudo","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Ogata","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7861-8383","authenticated-orcid":false,"given":"Kento","family":"Takenaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Institute of Science Tokyo , Tokyo, 113-8519,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Takabayashi","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine , Tokyo, 160-8582,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Kuroki","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yurie","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Okumura","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kouyama","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuro","family":"Ichimasa","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takemasa","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Baba","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Ogata","sequence":"additional","affiliation":[{"name":"Center for Preventive Medicine, Keio University , Tokyo, 106-0041,","place":["Japan"]},{"name":"Fujita Medical Innovation Center Tokyo , Tokyo, 144-0041,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Institute of Science Tokyo , Tokyo, 113-8519,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Mori","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo , Oslo, 0317","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta","family":"Iacucci","sequence":"additional","affiliation":[{"name":"APC Microbiome Ireland, College of Medicine and Health, University College Cork , Cork, T12 YT20,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Misawa","sequence":"additional","affiliation":[{"name":"Digestive Disease Center, Showa Medical University Northern Yokohama Hospital , Yokohama, Kanagawa, 224-8503,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026073017022120500_jjag115-B1","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1001\/jama.2023.15389","article-title":"Ulcerative colitis in adults: a review","volume":"330","author":"Gros","year":"2023","journal-title":"JAMA"},{"key":"2026073017022120500_jjag115-B2","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.14309\/ajg.0000000000003463","article-title":"ACG clinical guideline update: ulcerative colitis in 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