{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T12:43:34Z","timestamp":1773751414674,"version":"3.50.1"},"reference-count":17,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: High-resolution anoscopy (HRA) is the gold standard for anal cancer screening, but its interpretation is challenging and operator-dependent. Artificial intelligence (AI) may increase diagnostic yield, but most studies have focused on differentiating low-grade and high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively) in still frames, with no clinical application reported. Methods: We describe the first real-time use of deep learning, demonstrated in three patients undergoing HRA for anal cancer screening, at a high-volume American referral center. When an area suggestive of HSIL appeared, a YOLO-based object detection model generated a bounding box. Results: The model detected only histologically confirmed HSIL and did not activate when no lesions or only LSIL were present. Conclusions: This report suggests that real-time AI-enhanced HRA is feasible and may improve lesion detection and differentiation, potentially representing a significant step forward in this demanding field, although multicentric validation studies are still needed.<\/jats:p>","DOI":"10.3390\/jcm15062268","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T09:35:57Z","timestamp":1773740157000},"page":"2268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-Time Application of Artificial Intelligence for Automatic Detection of High-Grade Squamous Intraepithelial Lesions During High-Resolution Anoscopy"],"prefix":"10.3390","volume":"15","author":[{"given":"Luis","family":"Barroso","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Jo\u00e3o","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3659-8024","authenticated-orcid":false,"given":"Joana","family":"Mota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0402-2285","authenticated-orcid":false,"given":"Ahsan","family":"Javed","sequence":"additional","affiliation":[{"name":"Department of Surgery NHS, Royal Liverpool University Hospital, Liverpool L7 8XP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-0839","authenticated-orcid":false,"given":"Amine","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Proctology, GH Paris Saint-Joseph, 75674 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Fathallah","sequence":"additional","affiliation":[{"name":"Department of Proctology, GH Paris Saint-Joseph, 75674 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Diaz Donoso","sequence":"additional","affiliation":[{"name":"Private Center of Surgery and Proctology, Buenos 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Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidney","family":"Nadal","sequence":"additional","affiliation":[{"name":"Department of Surgery, Instituto de Infectologia Em\u00edlio Ribas, S\u00e3o Paulo 01246-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sim\u00e3o","family":"Faria","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1498-9089","authenticated-orcid":false,"given":"Vincent","family":"de Parades","sequence":"additional","affiliation":[{"name":"Department of Proctology, GH Paris Saint-Joseph, 75674 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0830","authenticated-orcid":false,"given":"Miguel","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, S\u00e3o Jo\u00e3o University Hospital, 4200-319 Porto, Portugal"},{"name":"Hepatology Training Center, WGO Gastroenterology, 4200-427 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4099-002 Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1055\/a-1950-5694","article-title":"Expected value of artificial intelligence in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position 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