{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:39:54Z","timestamp":1790221194953,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by continuous inflammation of the colon and rectum. Accurate disease assessment is essential for effective treatment, with endoscopic evaluation, particularly the Mayo Endoscopic Score (MES), serving as a key diagnostic tool. However, MES measurement can be subjective and inconsistent, leading to variability in treatment decisions. Deep learning approaches have shown promise in providing more objective and standardized assessments of UC severity. Methods: This study utilized publicly available endoscopic images of UC patients to analyze and compare the performance of state-of-the-art deep neural networks for automated MES classification. Several state-of-the-art architectures were tested to determine the most effective model for grading disease severity. The F1 score, accuracy, recall, and precision were calculated for all models, and statistical analysis was conducted to verify statistically significant differences between the networks. Results: VGG19 was found to be the best-performing network, achieving a QWK score of 0.876 and a macro-averaged F1 score of 0.7528 across all classes. However, the performance differences among the top-performing models were very small suggesting that selection should depend on specific deployment requirements. Conclusions: This study demonstrates that multiple state-of-the-art deep neural network architectures could automate UC severity classification. Simpler architectures were found to achieve competitive results with larger models, challenging the assumption that larger networks necessarily provide better clinical outcomes.<\/jats:p>","DOI":"10.3390\/bioengineering12040413","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T06:18:36Z","timestamp":1744611516000},"page":"413","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparative Analysis of Deep Neural Networks for Automated Ulcerative Colitis Severity Assessment"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7410-2689","authenticated-orcid":false,"given":"Andreas","family":"Vezakis","sequence":"first","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4976-4901","authenticated-orcid":false,"given":"Ioannis","family":"Vezakis","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ourania","family":"Petropoulou","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-5530","authenticated-orcid":false,"given":"Stavros T.","family":"Miloulis","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6679-3590","authenticated-orcid":false,"given":"Athanasios","family":"Anastasiou","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8365-2140","authenticated-orcid":false,"given":"Ioannis","family":"Kakkos","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"},{"name":"Department of Biomedical Engineering, University of West Attica, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2600-9914","authenticated-orcid":false,"given":"George K.","family":"Matsopoulos","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Laboratory, School of Electrical & Computer Engineering, National Technical University of Athens, 15773 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.cgh.2017.06.016","article-title":"Natural History of Adult Ulcerative Colitis in Population-based Cohorts: A Systematic Review","volume":"16","author":"Fumery","year":"2018","journal-title":"Clin. 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