{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:47:51Z","timestamp":1784544471371,"version":"3.55.0"},"reference-count":50,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Optical biopsy in Barrett\u2019s oesophagus (BE) using endocytoscopy (EC) could optimize endoscopic screening. However, the identification of dysplasia is challenging due to the complex interpretation of the highly detailed images. Therefore, we assessed whether using artificial intelligence (AI) as second assessor could help gastroenterologists in interpreting endocytoscopic BE images. First, we prospectively videotaped 52 BE patients with EC. Then we trained and tested the AI pm distinct datasets drawn from 83,277 frames, developed an endocytoscopic BE classification system, and designed online training and testing modules. We invited two successive cohorts for these online modules: 10 endoscopists to validate the classification system and 12 gastroenterologists to evaluate AI as second assessor by providing six of them with the option to request AI assistance. Training the endoscopists in the classification system established an improved sensitivity of 90.0% (+32.67%, p &lt; 0.001) and an accuracy of 77.67% (+13.0%, p = 0.020) compared with the baseline. However, these values deteriorated at follow-up (\u221216.67%, p &lt; 0.001 and -8.0%, p = 0.009). Contrastingly, AI-assisted gastroenterologists maintained high sensitivity and accuracy at follow-up, subsequently outperforming the unassisted gastroenterologists (+20.0%, p = 0.025 and +12.22%, p = 0.05). Thus, best diagnostic scores for the identification of dysplasia emerged through human\u2013machine collaboration between trained gastroenterologists with AI as the second assessor. Therefore, AI could support clinical implementation of optical biopsies through EC.<\/jats:p>","DOI":"10.3390\/cancers15071950","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T03:50:21Z","timestamp":1679629821000},"page":"1950","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Optical Biopsy of Dysplasia in Barrett\u2019s Oesophagus Assisted by Artificial Intelligence"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6727-715X","authenticated-orcid":false,"given":"Jouke J. H.","family":"van der Laan","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0915-9048","authenticated-orcid":false,"given":"Joost A.","family":"van der Putten","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Video Coding and Architectures, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arend","family":"Karrenbeld","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans T. M.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"Westerhof","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H. N.","family":"de With","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Video Coding and Architectures, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3593-2356","authenticated-orcid":false,"given":"Fons","family":"van der Sommen","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Video Coding and Architectures, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6164-1536","authenticated-orcid":false,"given":"Wouter B.","family":"Nagengast","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1053\/j.gastro.2017.07.046","article-title":"The Epidemiology of Esophageal Adenocarcinoma","volume":"154","author":"Coleman","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1136\/gutjnl-2014-308865","article-title":"Surveillance endoscopy is associated with improved outcomes of oesophageal adenocarcinoma detected in patients with Barrett\u2019s oesophagus","volume":"65","author":"Naik","year":"2016","journal-title":"Gut"},{"key":"ref_3","first-page":"265","article-title":"Long-term outcomes after endoscopic treatment for Barrett\u2019s neoplasia with radiofrequency ablation \u00b1 endoscopic resection: Results from the national Dutch database in a 10-year period","volume":"71","author":"Nieuwenhuis","year":"2021","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/gutjnl-2013-305372","article-title":"British Society of Gastroenterology guidelines on the diagnosis and management of Barrett\u2019s oesophagus","volume":"63","author":"Fitzgerald","year":"2014","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/ajg.2015.322","article-title":"ACG Clinical Guideline: Diagnosis and Management of Barrett\u2019s Esophagus","volume":"111","author":"Shaheen","year":"2016","journal-title":"Am. 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