{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:03Z","timestamp":1783318503855,"version":"3.54.6"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Gastroenterol."],"abstract":"<jats:p>Ischemic colitis remains a diagnostic challenge, as endoscopic grading of mucosal ischemia is subjective and insensitive for transmural infarction. While the majority of non-gangrenous cases are resolved conservatively, gangrenous mucosa necessitates immediate resection. The current reliance on visual signals, such as color and bleeding, results in misclassification and variability. We propose a novel deep learning approach to quantify micro-capillary refill dynamics from colonoscopy video. The technology produces objective perfusion measures and real-time viability classification by examining frame-by-frame color recovery following temporary mucosal blanching. This approach makes use of recent developments in AI-assisted colonoscopy, annotated datasets, and endoscopic hardware. By incorporating capillary refill analysis, operational decision-making might be improved, interobserver variability could be decreased, and unnecessary colectomy and delayed gangrene treatment could be avoided. Pilot studies are warranted to validate this concept and establish its role in guiding therapy for ischemic colitis.<\/jats:p>","DOI":"10.3389\/fgstr.2026.1782255","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:36:46Z","timestamp":1783316206000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Deep learning analysis of capillary refill dynamics in ischemic colitis: differentiating reversible vs. gangrenous mucosa"],"prefix":"10.3389","volume":"5","author":[{"given":"Zarqa","family":"Yasin","sequence":"first","affiliation":[{"name":"Henry Ford Jackson Hospital","place":["Michigan, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Sajid","sequence":"additional","affiliation":[{"name":"Allama Iqbal Medical College","place":["Lahore, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor ul Ain","family":"Saleem","sequence":"additional","affiliation":[{"name":"Fatima Memorial Hospital (FMH) College of Medicine and Dentistry","place":["Lahore, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Abu Nahla","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hebron University","place":["Hebron, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.7302","article-title":"Ischemic colitis: clinical practice in diagnosis and treatment","volume":"14","author":"Theodoropoulou","year":"2008","journal-title":"World J Gastroenterol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.ejvs.2018.02.008","article-title":"Accuracy of routine endoscopy diagnosing colonic ischaemia after abdominal aortic aneurysm repair: a meta-analysis","volume":"56","author":"von Meijenfeldt","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"6598","DOI":"10.1038\/s41598-022-10597-y","article-title":"Clinical evaluation of a real-time artificial intelligence-based polyp detection system: a US multi-center pilot study","volume":"12","author":"Quan","year":"2022","journal-title":"Sci Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-022-09764-z","article-title":"Quantification of bowel ischaemia using real-time multispectral single snapshot imaging of optical properties (SSOP)","volume":"37","author":"Rodr\u00edguez-Luna","year":"2023","journal-title":"Surg Endosc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/jimaging11030084","article-title":"Deep learning-based semantic segmentation for objective colonoscopy quality assessment","volume":"11","author":"Vulpoi","year":"2025","journal-title":"J Imaging"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/s22239111","article-title":"Assessment of intestinal ischemia\u2013reperfusion injury using diffuse reflectance VIS-NIR spectroscopy and histology","volume":"22","author":"Hou","year":"2022","journal-title":"Sensors"}],"container-title":["Frontiers in Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2026.1782255\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:36:46Z","timestamp":1783316206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgstr.2026.1782255\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":6,"alternative-id":["10.3389\/fgstr.2026.1782255"],"URL":"https:\/\/doi.org\/10.3389\/fgstr.2026.1782255","relation":{},"ISSN":["2813-1169"],"issn-type":[{"value":"2813-1169","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"article-number":"1782255"}}