{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:24:36Z","timestamp":1790375076129,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018699","name":"HORIZON EUROPE Digital, Industry and Space","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018699","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Treatment pathways for significant rectal polyps differ depending on the underlying pathology, but pre\u2010excision profiling is imperfect. It has been demonstrated that differences in fluorescence perfusion signals following injection of indocyanine green (ICG) can be analysed mathematically and, with the assistance of artificial intelligence (AI), used to classify tumours endoscopically as benign or malignant. This study aims to validate this method of characterization across multiple clinical sites regarding its generalizability, usability and accuracy while developing clinical\u2010grade software to enable it to become a useful method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The CLASSICA study is a prospective, unblinded multicentre European observational study aimed to validate the use of AI analysis of ICG fluorescence for intra\u2010operative tissue characterization. Six hundred patients undergoing transanal endoscopic evaluation of significant rectal polyps and tumours will be enrolled in at least five clinical sites across the European Union over a 4\u2010year period. Video recordings will be analysed regarding dynamic fluorescence patterns centrally as software is developed to enable analysis with automatic classification to happen locally. AI\u2010based classification and subsequently guided intervention will be compared with the current standard of care including biopsies, final specimen pathology and patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>CLASSICA will validate the use of AI in the analysis of ICG fluorescence for the purposes of classifying significant rectal polyps and tumours endoscopically. Follow\u2010on studies will compare AI\u2010guided targeted biopsy or, indeed, AI characterization alone with traditional biopsy and AI\u2010guided local excision versus traditional excision with regard to marginal clearance and recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16769","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T05:11:57Z","timestamp":1699333917000},"page":"2392-2402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["CLASSICA: Validating artificial intelligence in classifying cancer in real time during surgery"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-936X","authenticated-orcid":false,"given":"A.","family":"Moynihan","sequence":"first","affiliation":[{"name":"University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7036-3910","authenticated-orcid":false,"given":"N.","family":"Hardy","sequence":"additional","affiliation":[{"name":"University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Dalli","sequence":"additional","affiliation":[{"name":"University College Dublin  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Aigner","sequence":"additional","affiliation":[{"name":"Krankenhaus der Barmherzigen Br\u00fcder Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Arezzo","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences University of Torino  Torino Italy"},{"name":"European Association for Endoscopic Surgery  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hompes","sequence":"additional","affiliation":[{"name":"Ziekenhuis Oost\u2010Limburg Autonome Verzorgingsinstelling  Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Knol","sequence":"additional","affiliation":[{"name":"Ziekenhuis Oost\u2010Limburg Autonome Verzorgingsinstelling  Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5952-8000","authenticated-orcid":false,"given":"J.","family":"Tuynman","sequence":"additional","affiliation":[{"name":"Stitching VUMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cucek","sequence":"additional","affiliation":[{"name":"Arctur  Nova Gorica Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Rojc","sequence":"additional","affiliation":[{"name":"Arctur  Nova Gorica Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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