System and method for identifying images of polyps

Abstract

A system and method for identifying images containing polyps is disclosed. An exemplary method for identifying images includes accessing images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, where each image among the images is suspected of containing a polyp and is associated with a probability of containing a polyp, the images including seed images, and each seed image being associated with one or more images among the images. Images associated with each seed image are identified as suspected of containing the same polyp as the associated seed image. The method includes applying a polyp detection system to the seed images to identify the seed images containing polyps, where the polyp detection system is applied to each seed image based on the image associated with the seed image and the probability associated with the seed image and the associated image.

Description

[Technical Field]

[0001] (Cross-reference of related applications) This application claims the interests and priority of U.S. Provisional Patent Application No. 63 / 075,795, filed on 8 September 2020, which is incorporated herein by reference in its entirety.

[0002] (Field of Invention) This disclosure relates to the image analysis of in vivo images of the gastrointestinal tract (GIT), and more specifically, to a system and method for identifying images of polyps within the GIT. [Background technology]

[0003] Capsule endoscopy (CE) allows for endoscopic examination of the entire gastrointestinal tract (GIT). Capsule endoscopy systems and methods exist for examining specific portions of the GIT, such as the small intestine or colon. CE is a non-invasive procedure that does not require the patient to be hospitalized, and the patient can continue most daily activities while the capsule is inside their body.

[0004] In a typical CE procedure, the patient is referred for the procedure by a physician. The patient then arrives at a medical facility (e.g., a clinic or hospital) to undergo the procedure. A capsule, roughly the size of a multivitamin pill, is swallowed by the patient under the supervision of a medical professional (e.g., a nurse or physician) at the medical facility, and the patient is provided with a wearable device, such as a sensor belt, and a recorder placed in a pouch and strap positioned around the patient's shoulder. The wearable device typically includes a memory device. After being given guidance and / or instructions, the patient may be released to resume their daily activities.

[0005] The capsule captures images as it moves naturally through the GIT (Gastrointestinal Intestine Test). The images and additional data (e.g., metadata) are then transmitted to a recorder worn by the patient. The capsule is disposable and moves naturally with bowel movements. The procedure data (e.g., captured images or parts thereof and additional metadata) is stored on the memory device of the wearable device.

[0006] Wearable devices are typically returned to the healthcare facility by the patient, along with the treatment data stored on them. The treatment data is then downloaded to a computing device, typically located at the healthcare facility, which stores engine software. The received treatment data is then processed by the engine into a compiled survey (or "examination"). Typically, the survey contains thousands of images (around 6,000). Typically, the number of images processed ranges from tens of thousands to an average of around 90,000.

[0007] The leader (which may be a supervising physician, specialist, or attending physician) may access the survey via a leader application. The leader then reviews the survey, evaluates the procedure, and provides their input via the leader application. Because the leader needs to review thousands of images, the reading of the survey can typically take 30 minutes to an hour on average, and the reading process can be tedious. The leader application then generates a report based on the compiled survey and the leader's input. On average, it takes one hour to generate the report. The report may include, for example, images of interest, such as those identified as containing a pathological condition selected by the leader, and an assessment or diagnosis of the patient's medical condition based on the procedure data (i.e., the survey) and / or recommendations for follow-up and / or treatment provided by the leader. The report may then be forwarded to the attending physician. The attending physician can determine the necessary follow-up or treatment based on the report. [Overview of the Initiative] [Means for solving the problem]

[0008] Furthermore, to the extent that it does not contradict itself, any or all of the embodiments described herein may be used in conjunction with any or all of the other embodiments described herein. Embodiments of this disclosure relate to the identification of polyp images with high confidence. Due to the high confidence, embodiments of this disclosure relate to the automatic use of identified images without human assistance or intervention, and / or the presentation of identified images to medical professionals in cases where such images may have been overlooked during human review, and / or the invalidation of decisions of other tools that may have misidentified identified images.

[0009] According to aspects of the present disclosure, the method for identifying images containing polyps includes accessing a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device during a CE procedure, wherein each of the plurality of images is suspected to contain a polyp and is associated with a probability of containing a polyp, the plurality of images include seed images, each seed image is associated with one or more of the plurality of images, and one or more images associated with each seed image are identified as suspected to contain the same polyp as the associated seed image, and applying a polyp detection system to the seed images in order to identify seed images containing polyps, wherein the polyp detection system is applied to each seed image of the seed image based on one or more images associated with the seed image and the probabilities associated with the seed image and the one or more associated images.

[0010] In various embodiments of the method, the method includes identifying images of a plurality of images containing polyps of a size greater than or equal to a predetermined size, each image of the plurality of images being further associated with an estimated size of a suspected polyp contained in each image, and the polyp detection system is further applied to each seed image of the seed image based on the estimated polyp size associated with the seed image and one or more images associated with the seed image.

[0011] In various embodiments of this method, a procedure is determined to be inappropriate and excluded, and at least one seed image is identified as containing a polyp of a certain size or larger, or a certain number of polyps of a certain size or larger, and the method includes invalidating the exclusion of the procedure.

[0012] In various embodiments of this method, the polyp detection system includes at least one of one or more positive filters, one or more negative filters, one or more classical machine learning systems, or a combination thereof.

[0013] In various embodiments of this method, the input to one or more classical machine learning systems, one or more positive filters, or one or more negative filters includes at least one of the following: the probability of a seed image containing a polyp, the number of images associated with a seed image, the number of images associated with a seed image having a probability of containing a polyp by a predetermined threshold, or a combination thereof.

[0014] In various embodiments of this method, one or more images associated with each seed image are determined by applying a tracker that tracks suspicious polyps contained in each seed image within adjacent images, or by using a classification system that compares the seed image with adjacent images.

[0015] In various embodiments of this method, the multiple images accessed from the gastrointestinal tract (GIT) are images from the CE treatment investigation.

[0016] In various embodiments of this method, the method includes selecting a seed image from a plurality of images.

[0017] In various embodiments of the Method, the Method includes providing instructions to a CE procedure physician to refer to a CE procedure undergoing a colonoscopy procedure based on a seed image identified as containing a polyp.

[0018] In various embodiments of the method, the method includes applying a classical machine learning system configured to provide, for each of a plurality of images, a probability that the image includes a polyp based on input features corresponding to the image, accessing a soft margin of the classical machine learning system corresponding to the image, and determining, without human intervention, whether to recommend a colonoscopy based on the soft margins of the plurality of images.

[0019] In various embodiments of the method, the method includes accessing a mapping of soft margins to the probability of an image including a polyp, and determining whether to recommend a colonoscopy is further based on the mapping of soft margins to the probability of an image including a polyp.

[0020] In various embodiments of the method, the method includes, for each of a plurality of images, accessing an estimated polyp size of the image, where the estimated polyp size is generated based on the image, and accessing a mapping of the estimated polyp size to the probability of an actual polyp size that is at least a predetermined size, and the determination of whether to recommend a colonoscopy is further based on the estimated polyp size and the mapping of the estimated polyp size to the probability of an actual polyp size that is at least a predetermined size.

[0021] In various embodiments of the method, the method includes displaying a seed image identified as including a polyp.

[0022] In various embodiments of the method, the method includes providing a treatment recommendation based on a seed image identified as including a polyp.

[0023] [[ID=I9]] In various embodiments of the method, the method includes displaying a seed image and indicating the seed image identified as including a polyp.

[0024] In various embodiments of the method, the method includes at least displaying a seed image to a user, receiving a user selection of an image from the displayed images, determining at least one unselected image that is not selected by the user and is among the seed images identified as including a polyp, and presenting at least one unselected image to the user.

[0025] In various embodiments of the method, the image selected by the user is an image selected to be included in a CE procedure report.

[0026] In various embodiments of the method, in the method, presenting at least one unselected image to the user is performed when a request to generate a report is received.

[0027] According to an aspect of the present disclosure, a method for identifying an image includes accessing a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscope device, the plurality of images having the possibility of including a polyp, applying at least one filter to the plurality of images, the at least one filter including at least one of a positive filter configured to identify an image designated as including a polyp or a negative filter configured to identify an image not designated as including a polyp, and providing information based on at least one of at least one image identified by the at least one filter or at least one image not identified by the at least one filter among the plurality of images.

[0028] In various embodiments of the method, the negative filter is configured to identify an image not designated as including a polyp based on the image being an image of the body outlet portion of the GIT.

[0029] In various embodiments of this method, the negative filter is configured to identify images that are not designated as containing polyps, based on images that are evaluated to be images of at least one of the ileocecal valve or hemorrhoidal venous plexus.

[0030] In various embodiments of this method, the negative filter is configured to identify images that are not designated as containing polyps, based on images that are evaluated as containing polyps whose estimated polyp size is less than a threshold size.

[0031] In various embodiments of this method, the method further includes accessing the image track of each image in a plurality of images.

[0032] In various embodiments of this method, the negative filter is configured to identify images that are not designated as containing polyps, based on the image track for images that have only one image with a polyp presence probability exceeding a threshold.

[0033] In various embodiments of this method, the positive filter is configured to identify images that are designated as containing polyps based on the image's track.

[0034] In various embodiments of this method, the positive filter is configured to identify images designated as containing polyps based on image tracks for images having at least a threshold number of images with a polyp presence probability above a threshold.

[0035] According to aspects of the present disclosure, a system for identifying images includes one or more processors and at least one memory for storing instructions. When executed by one or more processors, instructions cause the system to access a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, the plurality of images may contain polyps, and to apply at least one filter to the plurality of images, the at least one filter including at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps, and to provide information based on at least one of at least one of the plurality of images identified by at least one filter, or at least one of the plurality of images not identified by at least one filter.

[0036] In various embodiments of this system, the negative filter is configured to identify images that are not designated as containing polyps, based on the fact that the image is an image of the body exit portion of the GIT.

[0037] In various embodiments of this system, the negative filter is configured to identify images that are not designated as containing polyps, based on images that are evaluated to be images of at least one of the ileocecal valve or hemorrhoidal venous plexus.

[0038] In various embodiments of this system, the negative filter is configured to identify images that are not designated as containing polyps, based on images that are evaluated as containing polyps whose estimated polyp size is less than a threshold size.

[0039] In various embodiments of this system, when an instruction is executed by one or more processors, it further causes the system to access the image track for each of the multiple images.

[0040] In various embodiments of this system, the negative filter is configured to identify images that are not designated as containing polyps, based on the image track for images that have only one image with a polyp presence probability exceeding a threshold.

[0041] In various embodiments of this system, the positive filter is configured to identify images that are designated as containing polyps based on the image's track.

[0042] In various embodiments of this system, the positive filter is configured to identify images designated as containing polyps based on image tracks for images having at least a threshold number of images with a polyp presence probability above a threshold.

[0043] According to aspects of the present disclosure, a method for identifying an image includes accessing a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the plurality of images may contain polyps; applying a classical machine learning system configured to provide an indication, based on input features corresponding to the image, whether the image contains polyps or not; and presenting information based on at least one of the plurality of images having an indication provided by the classical machine learning system that contains polyps, satisfying a confidence threshold.

[0044] In various embodiments of this method, the method further includes accessing the image track of each image in a plurality of images.

[0045] In various embodiments of this method, the input features corresponding to an image include at least one of the following: the track length of the image track, or the number of images in the image track having a polyp presence score above a threshold.

[0046] In various embodiments of this method, the input feature corresponding to the image includes an index difference between the index of the image and the index of the image of the ileocecal valve.

[0047] In various embodiments of this method, the input features corresponding to the image include the classification number of the colonic segment in which the image was captured.

[0048] In various embodiments of this method, the classical machine learning classifier is a polynomial support vector machine.

[0049] According to aspects of the present disclosure, a system for identifying images includes one or more processors and at least one memory for storing instructions. When an instruction is executed by one or more processors, it causes the system to access a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, the plurality of images may contain polyps, and for each of the plurality of images, it causes the system to apply a classical machine learning system configured to provide an indication whether the image contains polyps or not, based on input features corresponding to the image, and to present information based on at least one of the plurality of images having an indication provided by the classical machine learning system that contains polyps, satisfying a confidence threshold.

[0050] In various embodiments of this system, when an instruction is executed by one or more processors, it further causes the system to access the image track for each of the multiple images.

[0051] In various embodiments of this system, the input features corresponding to an image include at least one of the following: the track length of the image track, or the number of images in the image track having a polyp presence score above a threshold.

[0052] In various embodiments of this system, the input features corresponding to an image include an index difference between the index of the image and the index of the image of the ileocecal valve.

[0053] In various embodiments of this system, the input features corresponding to the image include the classification number of the colonic segment in which the image was captured.

[0054] In various embodiments of this system, the classical machine learning classifier is a polynomial support vector machine.

[0055] According to aspects of the present disclosure, a method for identifying an image includes: accessing a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the plurality of images may contain polyps; applying at least one filter to the plurality of images, wherein the at least one filter includes at least one of a positive filter configured to identify an image designated as containing polyps, or a negative filter configured to identify an image not designated as containing polyps; providing at least one unfiltered image by selecting at least one image from the plurality of images that was not identified by at least one filter; applying a classical machine learning system configured to provide an indication for each of the at least one unfiltered image of the at least one unfiltered image whether the unfiltered image contains polyps or not, based on input features corresponding to the unfiltered image; and presenting information based on at least one of the at least one unfiltered image having an indication provided by the classical machine learning system that contains polyps, satisfying a confidence threshold.

[0056] In various embodiments of the present method, the method further comprises generating a capsule endoscopy report to be presented to a clinician without human intervention, wherein the capsule endoscopy report includes at least one of at least one unfiltered image having indications, provided by a classical machine learning system including polyps that satisfy a confidence threshold, or at least one image identified by a positive filter.

[0057] In various embodiments of the method, the method further includes receiving a user selection of an image from a plurality of images, determining at least one unselected image from at least one of at least one unfiltered images that were not selected by the user and that satisfy a confidence threshold, and having instructions provided by a classical machine learning system including polyps, and presenting the at least one unselected image to the user.

[0058] According to aspects of the present disclosure, a system for identifying images includes one or more processors and at least one memory for storing instructions. When an instruction is executed by one or more processors, it causes the system to access a plurality of images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, the plurality of images may contain polyps, and to apply at least one filter to the plurality of images, the at least one filter including at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps, and to provide at least one unfiltered image by selecting at least one image from the plurality of images that was not identified by at least one filter, and for each of the at least one unfiltered image, to apply a classical machine learning system configured to provide an indication of whether the unfiltered image contains polyps or not, based on input features corresponding to the unfiltered image, and to present information based on at least one of the at least one unfiltered image that has an indication provided by the classical machine learning system that contains polyps and satisfies a confidence threshold.

[0059] In various embodiments of the system, when an instruction is executed by one or more processors, the system further causes the system to generate a capsule endoscopy report for presentation to a clinician without human intervention, the capsule endoscopy report comprising at least one of at least one unfiltered image having an indication of polyps provided by a classical machine learning system, which satisfies a confidence threshold, or at least one image identified by a positive filter.

[0060] In various embodiments of this system, when an instruction is executed by one or more processors, the system is further caused to receive a user selection of an image from a plurality of images, to determine at least one unselected image from at least one unfiltered image that has instructions provided by a classical machine learning system including polyps that were not selected by the user and satisfy a confidence threshold, and to present at least one unselected image to the user.

[0061] According to aspects of the present disclosure, a computer-aided method for recommending colonoscopy includes: accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may contain polyps; applying a classical machine learning system configured to provide an indication, based on input features corresponding to the image, whether the image contains polyps or not; accessing the soft margins of the classical machine learning system corresponding to the images; and determining, without human intervention, whether to recommend colonoscopy based on the soft margins of the multiple images.

[0062] In various embodiments of the method, the method further includes accessing a soft margin mapping to the probability of images containing polyps, and the decision of whether or not to recommend colonoscopy is further based on the soft margin mapping to the probability of images containing polyps.

[0063] In various embodiments of the method, the method further includes, for each image of a plurality of images, accessing the estimated polyp size of the image, the estimated polyp size being generated based on the image, and accessing a mapping of the estimated polyp size to the probability of an actual polyp size being at least a predetermined size, and the decision on whether to recommend colonoscopy is further based on the estimated polyp size and the mapping of the estimated polyp size to the probability of an actual polyp size being at least a predetermined size.

[0064] According to aspects of the present disclosure, a system for recommending colonoscopy includes one or more processors and at least one memory for storing instructions. When an instruction is executed by one or more processors, it causes the system to access multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, the multiple images may contain polyps, and for each of the multiple images, it applies a classical machine learning system configured to provide instructions on whether the image contains polyps or not based on input features corresponding to the image, accesses the soft margins of the classical machine learning system corresponding to the images, and, without human intervention, determines whether to recommend colonoscopy based on the soft margins of the multiple images.

[0065] In various embodiments of this system, when an instruction is executed by one or more processors, the system is further given access to a mapping of soft margins to the probability of images containing polyps, and the decision of whether or not to recommend a colonoscopy is further based on this mapping of soft margins to the probability of images containing polyps.

[0066] In various embodiments of this system, when an instruction is executed by one or more processors, the system is further given access to the estimated polyp size of each of a plurality of images, the estimated polyp size is generated based on the image and is given access to a mapping of the estimated polyp size to the probability of an actual polyp size being at least a predetermined size, and the decision of whether to recommend a colonoscopy is further based on the estimated polyp size and the mapping of the estimated polyp size to the probability of an actual polyp size being at least a predetermined size. The present invention provides, for example, the following items: (Item 1) A method for identifying an image containing polyps, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device during CE procedure, Each of the aforementioned images is suspected to contain a polyp, and is associated with the probability of containing the polyp. The plurality of images include seed images, each seed image is associated with one or more of the plurality of images, and the one or more images associated with each seed image are identified as suspected to contain the same polyp as the associated seed image, To identify a seed image containing polyps, a polyp detection system is applied to the seed image, wherein the polyp detection system is applied to each seed image of the seed image based on one or more images associated with the seed image and the probabilities associated with the seed image and the one or more associated images. Methods that include... (Item 2) The method according to item 1, further comprising identifying images of the plurality of images that include polyps of a size greater than or equal to a predetermined size, each image of the plurality of images being further associated with an estimated size of the suspected polyp contained in each image, and the polyp detection system being further applied to each seed image of the seed image based on the seed image and the one or more images associated with the seed image. (Item 3) The method of item 2, wherein the procedure is determined to be inappropriate and excluded, and at least one seed image is identified as containing a polyp of a size greater than or equal to the predetermined size, or containing a predetermined number of polyps of a size greater than or equal to the predetermined size, and the method further comprises invalidating the exclusion of the procedure. (Item 4) The polyp detection system according to item 1, comprising at least one of one or more positive filters, one or more negative filters, one or more classical machine learning systems, or a combination thereof. (Item 5) The method according to item 4, wherein the input to the one or more classical machine learning systems, the one or more positive filters, or the one or more negative filters includes at least one of the following: the probability of a seed image containing a polyp, the number of images associated with a seed image, the number of images associated with a seed image having a probability of containing a polyp according to a predetermined threshold, or a combination thereof. (Item 6) The method according to item 1, wherein the one or more images associated with each seed image are determined by applying a tracker that tracks the suspected polyps contained in each seed image within adjacent images, or by using a classification system that compares the seed images with adjacent images. (Item 7) The method according to item 1, wherein the multiple accessed images of the gastrointestinal tract (GIT) are images of the CE treatment investigation. (Item 8) The method according to item 1, further comprising selecting the seed image from the aforementioned plurality of images. (Item 9) The method according to item 1, further comprising providing the physician in charge of the CE procedure with instructions to direct the subject of the CE procedure to a colonoscopy procedure based on the seed image identified as containing a polyp. (Item 10) For each of the aforementioned multiple images, Applying a classical machine learning system configured to provide the probability that the image contains the polyp based on the input features corresponding to the image, Accessing the soft margin of the classical machine learning system corresponding to the aforementioned image, The method according to item 9, further comprising determining whether to recommend a colonoscopy based on the soft margins of the plurality of images without human intervention. (Item 11) This further includes accessing a mapping of soft margins to the probability of images containing polyps, The method according to item 10, wherein the decision on whether or not to recommend a colonoscopy is further based on the mapping of soft margins to the probability of images containing polyps. (Item 12) For each of the aforementioned plurality of images, access is provided for the estimated polyp size of the image, wherein the estimated polyp size is generated based on the image. This further includes accessing a mapping of estimated polyp sizes to the probability of actual polyp sizes being at least a given size, The method according to item 10, wherein the decision on whether to recommend colonoscopy is further based on the estimated polyp size and a mapping of the estimated polyp size to the probability that the actual polyp size is at least a predetermined size. (Item 13) The method according to item 1, further comprising displaying the seed image identified as containing a polyp. (Item 14) The method according to item 1, further comprising providing treatment recommendations based on the seed image identified as containing a polyp. (Item 15) The method according to item 1, further comprising displaying the seed image and showing the seed image identified as containing a polyp. (Item 16) At least the seed image is displayed to the user, The system receives the user's selection of an image from the displayed images, To determine at least one unselected image among the seed images that has not been selected by the user and has been identified as containing a polyp, The method according to item 1, further comprising presenting the user with at least one unselected image. (Item 17) The method according to item 16, wherein the image selected by the user is an image selected to be included in the CE treatment report. (Item 18) The method of item 17, wherein presenting the user with at least one unselected image is performed when a request to generate a report is received. (Item 19) A method for image recognition, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps, Applying at least one filter to the plurality of images, wherein the at least one filter includes at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps. To provide information based on at least one of the images identified by the at least one filter, or at least one of the images not identified by the at least one filter, Methods that include... (Item 20) The method according to item 19, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the fact that the image is an image of the body exit portion of the GIT. (Item 21) The method according to item 19, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the images which are evaluated to be images of at least one of the ileocecal valve or hemorrhoidal venous plexus. (Item 22) The method according to item 19, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the images which are evaluated as containing polyps whose estimated polyp size is less than a threshold size. (Item 23) The method according to item 19, further comprising accessing the image track of each of the plurality of images. (Item 24) The method according to item 23, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the image track for images that have only one image with a polyp presence probability exceeding a threshold. (Item 25) The method according to item 23, wherein the positive filter is configured to identify an image that is designated as containing a polyp based on the track of the image. (Item 26) The method according to item 25, wherein the positive filter is configured to identify images designated as containing polyps based on the image tracks for images having at least a threshold number of images with a polyp presence probability above a threshold. (Item 27) A system for image recognition, One or more processors, The system comprises at least one memory for storing instructions, and when an instruction is executed by the one or more processors, the system Multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device are accessed, and these multiple images may contain polyps. Applying at least one filter to the plurality of images, wherein the at least one filter includes at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps. A system that provides information based on at least one of the plurality of images identified by the at least one filter, or at least one of the plurality of images not identified by the at least one filter. (Item 28) The system according to item 27, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the fact that the image is an image of the body exit portion of the GIT. (Item 29) The system according to item 27, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the images which are evaluated to be images of at least one of the ileocecal valve or hemorrhoidal venous plexus. (Item 30) The system according to item 27, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the images which are evaluated as containing polyps whose estimated polyp size is less than a threshold size. (Item 31) The system according to item 27, wherein, when the instruction is executed by one or more processors, the system further causes the system to access the image track for each of the plurality of images. (Item 32) The method according to item 31, wherein the negative filter is configured to identify images that are not designated as containing polyps, based on the image track for images that have only one image with a polyp presence probability exceeding a threshold. (Item 33) The positive filter is configured to identify images that are designated as containing polyps based on the tracks of the images, according to the system in item 31. (Item 34) The system according to item 33, wherein the positive filter is configured to identify images designated as containing polyps based on the image tracks for images having at least a threshold number of images with a polyp presence probability above a threshold. (Item 35) A method for image recognition, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps, For each of the aforementioned multiple images, a classical machine learning system is applied that is configured to provide an indication of whether the image contains a polyp or not, based on the input features corresponding to the image. Presenting information based on at least one of the multiple images having instructions provided by the classical machine learning system, including polyps, that satisfy a confidence threshold, Methods that include... (Item 36) The method according to item 35, further comprising accessing the image track of each of the plurality of images. (Item 37) The method according to item 36, wherein the input feature corresponding to the image includes at least one of the track length of the image's track, or the number of images in the image's track having a polyp presence score above a threshold. (Item 38) The method according to item 35, wherein the input feature corresponding to the image includes an index difference between the index of the image and the index of the image of the ileocecal valve. (Item 39) The method according to item 35, wherein the input feature corresponding to the image includes the classification number of the colon segment in which the image was captured. (Item 40) The aforementioned classical machine learning classifier is a polynomial support vector machine, as described in item 35. (Item 41) A system for image recognition, One or more processors, The system comprises at least one memory for storing instructions, and when an instruction is executed by the one or more processors, the system Multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device are accessed, and these multiple images may contain polyps. For each of the aforementioned plurality of images, a classical machine learning system is applied that is configured to provide an indication of whether the image contains a polyp or not, based on the input features corresponding to the image. A system that causes information to be presented based on at least one of a plurality of images having instructions provided by the classical machine learning system, which includes polyps, satisfying a confidence threshold. (Item 42) The system according to item 41, wherein, when the instruction is executed by one or more processors, the system further causes the system to access the image track for each of the plurality of images. (Item 43) The system according to item 42, wherein the input feature corresponding to the image includes at least one of the track length of the image's track, or the number of images in the image's track having a polyp presence score exceeding a threshold. (Item 44) The system according to item 41, wherein the input feature corresponding to the image includes an index difference between the index of the image and the index of the image of the ileocecal valve. (Item 45) The system according to item 41, wherein the input feature corresponding to the image includes the classification number of the colon segment in which the image was captured. (Item 46) The aforementioned classical machine learning classifier is a polynomial support vector machine, as described in item 41. (Item 47) A method for image recognition, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps, Applying at least one filter to the plurality of images, wherein the at least one filter includes at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps. To provide at least one unfiltered image by selecting at least one image from the plurality of images that was not identified by the at least one filter, For each of the at least one unfiltered image, a classical machine learning system is applied that is configured to provide an indication of whether the unfiltered image contains polyps or does not contain polyps, based on the input features corresponding to the unfiltered image. Presenting information based on at least one of the at least one unfiltered image having instructions provided by the classical machine learning system, including polyps, that satisfy a confidence threshold, Methods that include... (Item 48) The method according to item 47, further comprising generating a capsule endoscopy report to be presented to a clinician without human intervention, wherein the capsule endoscopy report includes at least one of the at least one unfiltered image having indications provided by the classical machine learning system, which includes polyps that satisfy a confidence threshold, or at least one image identified by a positive filter. (Item 49) Receiving the user's selection of an image from the aforementioned multiple images, Determining at least one unselected image among the at least one unfiltered image having instructions provided by the classical machine learning system, including polyps that were not selected by the user and satisfy a confidence threshold, The method of item 47, further comprising presenting the user with at least one unselected image. (Item 50) To provide at least one polyp image by accessing each of the at least one unfiltered image having instructions provided by the classical machine learning system, which includes the polyp, that satisfy a confidence threshold, Identifying a polyp image from among the at least one polyp image that was not designated as containing a polyp by another computer execution tool, The method of item 47, further comprising disabling the other computer execution tool in order to designate the polyp image as containing a polyp. (Item 51) A system for image recognition, One or more processors, The system comprises at least one memory for storing instructions, and when an instruction is executed by the one or more processors, the system Multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device are accessed, and these multiple images may contain polyps. Applying at least one filter to the plurality of images, wherein the at least one filter includes at least one of a positive filter configured to identify images designated as containing polyps, or a negative filter configured to identify images not designated as containing polyps. By selecting at least one image from the plurality of images that was not identified by the at least one filter, at least one unfiltered image is provided. For each of the at least one unfiltered image, a classical machine learning system is applied that is configured to provide an indication of whether the unfiltered image contains polyps or does not contain polyps, based on the input features corresponding to the unfiltered image. A system that causes information to be presented based on at least one of the at least one unfiltered images having instructions provided by the classical machine learning system, which includes polyps, satisfying a confidence threshold. (Item 52) When the instruction is executed by one or more processors, the system further: The system according to item 51, which generates a capsule endoscopy report to be presented to a clinician without human intervention, wherein the capsule endoscopy report includes at least one of the at least one unfiltered image having indications provided by the classical machine learning system, which includes polyps that satisfy a confidence threshold, or at least one image identified by a positive filter. (Item 53) When the instruction is executed by one or more processors, the system further: The user selects an image from the aforementioned multiple images, Determine at least one unselected image among the at least one unfiltered image that has instructions provided by the classical machine learning system, including polyps that were not selected by the user and satisfy a confidence threshold. The system according to item 51, which causes the user to present at least one unselected image. (Item 54) A computerized method for recommending colonoscopy, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps, For each of the aforementioned multiple images, Applying a classical machine learning system configured to provide an indication of whether the image contains polyps or not, based on the input features corresponding to the image, Accessing the soft margin of the classical machine learning system corresponding to the aforementioned image, To determine whether to recommend colonoscopy based on the soft margins of the aforementioned multiple images, without human intervention, A computer implementation method including (Item 55) This further includes accessing a mapping of soft margins to the probability of images containing polyps, The computer-aided method described in item 54 further depends on the mapping of soft margins to the probability of images containing polyps in the computer-aided method for recommending colonoscopy. (Item 56) For each of the aforementioned plurality of images, access is provided for the estimated polyp size of the image, wherein the estimated polyp size is generated based on the image. This further includes accessing a mapping of estimated polyp sizes to the probability of actual polyp sizes being at least a given size, The computer-aided method described in item 54 further relates the estimated polyp size to a mapping of the estimated polyp size to the probability of an actual polyp size being at least a predetermined size. (Item 57) This is a system for recommending colonoscopy. One or more processors, The system comprises at least one memory for storing instructions, and when an instruction is executed by the one or more processors, the system Multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device are accessed, and these multiple images may contain polyps. For each of the aforementioned multiple images, A classical machine learning system is applied that is configured to provide an indication of whether the image contains polyps or not, based on the input features corresponding to the image. Allow access to the soft margin of the classical machine learning system corresponding to the aforementioned image, A system that, without human intervention, determines whether to recommend a colonoscopy based on the soft margins of the aforementioned multiple images. (Item 58) When the instruction is executed by one or more processors, it further causes the system to access a mapping of soft margins to the probabilities of images containing polyps. The decision of whether or not to recommend a colonoscopy is based further on the mapping of soft margins to the probability of images containing polyps, as described in item 57. (Item 59) When the instruction is executed by one or more processors, the system further: For each of the aforementioned plurality of images, the estimated polyp size of the image is accessed, and the estimated polyp size is generated based on the image. Allow access to a mapping of estimated polyp sizes to the probability of actual polyp sizes being at least a given size. The system described in item 57, wherein the decision on whether to recommend colonoscopy is further based on the estimated polyp size and a mapping of the estimated polyp size to the probability of the actual polyp size being at least a predetermined size. [Brief explanation of the drawing]

[0067] The above-mentioned and other aspects and features of this disclosure will become more apparent upon consideration of the following detailed description in conjunction with the accompanying drawings. In the accompanying drawings, similar reference numerals identify similar or identical elements.

[0068] [Figure 1] This is a diagram of the digestive tract (GIT). [Figure 2] This is a block diagram of an exemplary system for analyzing medical images captured in vivo via capsule endoscopy (CE) procedures, according to aspects of the present disclosure. [Figure 3] This is a block diagram of an exemplary computing system that may be used in conjunction with the system of this disclosure. [Figure 4] This is a diagram of the colon. [Figure 5] This is a diagram of an exemplary deep learning neural network according to the embodiments of this disclosure. [Figure 6] This is a block diagram of an exemplary operation for selecting colon images containing colon polyps with high reliability according to an aspect of the present disclosure. [Figure 7] This is a diagram of a selected seed image according to the aspects of this disclosure. [Figure 8] This is a block diagram of an exemplary operation for selecting a colon image containing polyps according to an aspect of the present disclosure. [Figure 9] This is a block diagram of another exemplary operation for selecting a colon image containing polyps according to an aspect of the present disclosure. [Figure 10] This is a diagram illustrating an example image track of a seed image according to an aspect of the present disclosure. [Figure 11] This is a diagram of an exemplary image track processed by a positive filter according to an aspect of the present disclosure. [Figure 12] An exemplary display screen and user interface for a clinician to review and / or select colon images that may contain colon polyps, according to aspects of the present disclosure. [Figure 13] An exemplary display screen and user interface for presenting proposed images including polyps to a clinician, according to the embodiments of this disclosure. [Figure 14] An exemplary display screen for a fully automated process that presents selected colon images including polyps, according to an aspect of the present disclosure. [Figure 15] A graph for determining the probability that an image contains a polyp based on a soft margin, according to an aspect of this disclosure. [Figure 16] A graph for determining the probability that an image contains a polyp of at least 6 mm in size, according to an aspect of this disclosure. [Figure 17] This is a block diagram of another exemplary operation for selecting colon images containing colon polyps with high confidence, according to an aspect of the present disclosure. [Modes for carrying out the invention]

[0069] This disclosure relates to a system and method for reliably identifying images of polyps captured in vivo by a capsule endoscopy (CE) device. Due to the high reliability, aspects of this disclosure relate to automatically using identified images without human assistance or intervention, and / or presenting identified images to a medical professional if such images may have been overlooked during human review, and / or invalidating decisions of other tools that may have misidentified identified images. In various aspects, the decision about the target image uses image information related to the target image, such as image “track” information, which will be described in more detail later herein. In various aspects, the decision about the target image uses weights such that not all images are considered equally. Aspects of this disclosure involve deep learning machine learning in classification / detection to obtain relatively high sensitivity and specificity, and aspects of this disclosure use heuristic and / or “classical” machine learning (as defined later) to optimize the results and increase sensitivity and / or specificity.

[0070] The following detailed description includes specific details to provide a complete understanding of the disclosure. However, those skilled in the art will understand that the disclosure may be implemented without these specific details. In other examples, well-known methods, procedures, and components are not described in detail so as not to obscure the disclosure. Some features or elements described in relation to one system may be combined with features or elements described in relation to another system. For clarity, descriptions of the same or similar features or elements may not be repeated.

[0071] This disclosure is not limited in this respect, but descriptions using terms such as “process,” “calculate,” “calculate,” “determine,” “establish,” “analyze,” and “verify” may refer to the operation(s) and / or process(s) of a computer, computing platform, computing system, or other electronic computing device, which manipulates and / or converts data represented as physical (e.g., electronic) quantities in the computer’s registers and / or memory to other data similarly represented as physical quantities in the computer’s registers and / or memory, or other information in a non-temporary storage medium that can store instructions for performing operations and / or processes. This disclosure is not limited in this respect, but as used herein, “plurality” and “a plurality” may include, for example, “multiple” or “two or more.” The terms “plurality” or “a plurality” may be used throughout this specification to describe two or more components, devices, elements, units, parameters, etc. As used herein, the term set may include one or more items. Unless otherwise stated, the methods described herein are not limited to any particular order or sequence. In addition, some of the methods or elements thereof described may occur or be performed simultaneously, at the same time, or together.

[0072] The term "location" and its derivatives may refer to the estimated location of a capsule along the GIT (e.g., the colon) while capturing an image, or the estimated location of a portion of the GIT scattered across the image along the GIT, as referred to herein with respect to the image.

[0073] The type of CE procedure may be determined, in particular, based on the area of ​​interest and the portion of the GIT being imaged (e.g., the colon), or based on a specific use (e.g., to confirm the status of a G1 disease such as Crohn's disease, or for screening for colon cancer).

[0074] In this specification, the terms screen(s), view(s), and display(s) may be used interchangeably and may be understood according to the specific context.

[0075] The terms “surrounding” or “adjacent” may refer to spatial and / or temporal characteristics, unless otherwise specified, as they are used herein in reference to images (e.g., images surrounding or adjacent to other images). For example, images surrounding or adjacent to other images may be images that are estimated to be located near other images along the GIT, and / or images captured within a certain threshold, e.g., within 1 cm or 2 cm, or within 1 second, 5 seconds, or 10 seconds of the capture time of another image.

[0076] The terms "GIT" and "part of GIT" may, depending on the context, refer to or include the other. Therefore, "part of GIT" may also refer to the entire GIT, and "GIT" may also refer to only the part of GIT.

[0077] The terms “image” and “frame” may refer to or include the other, and may be used interchangeably in this disclosure to refer to a single capture by an imaging device. For convenience, the term “image” may be used more frequently in this disclosure, but references to images will be understood to also apply to frames.

[0078] The term "classical machine learning" refers to machine learning that involves feature selection or feature engineering for the input to the machine learning process.

[0079] The term "soft margin" can refer to the continuous output of a classifier (e.g., a classical machine learning algorithm) related to the distance between the example and the classifier's separating hyperplane / classification boundary. The soft margin can be used to assess how confident the classifier is in its decision. A higher absolute value of the soft margin indicates a greater distance from the classification boundary and greater confidence in the decision. The term "hard margin" can refer to the classification decision resulting from applying a threshold (e.g., 0) to the soft margin to determine which class each example belongs to.

[0080] The term "clinician" may refer to any healthcare provider or medical professional, including any physician such as a gastroenterologist, primary care physician, or attending physician.

[0081] Referring to Figure 1, a diagram of the GIT100 is shown. The GIT100 is an organ system found in humans and other animals. The GIT100 generally includes the mouth 102 for taking in food, salivary glands 104 for producing saliva, the esophagus 106 through which food passes with the assistance of contraction, the stomach 108 for secreting enzymes and gastric acid to aid in the digestion of food, the liver 110, the gallbladder 112, the pancreas 114, the small intestine / small bowel 116 ("SB") for absorbing nutrients, and the colon 400 (e.g., the large intestine) for storing water and waste as feces before defecation. The colon 400 generally includes the appendix 402, the rectum 428, and the anus 430. Food taken in through the mouth is digested by the GIT to absorb nutrients, and the remaining waste is expelled as feces from the anus 430.

[0082] Examination of different parts of the GIT100 (e.g., colon 400, esophagus 106, and / or stomach 108) may be presented via an appropriate user interface. As stated above, the term “examination” refers to and includes, optionally, at least a set of images selected from images captured by a CE imaging device (e.g., 212, Figure 2) during a single CE procedure performed for a particular patient and for a particular time, and may also include non-image information. The type of procedure performed can determine which part of the GIT100 is of interest. Examples of the types of procedures performed include, but are not limited to, small bowel procedures, colon procedures, small and colon procedures, procedures aimed at specifically presenting or confirming the small bowel, procedures aimed at specifically presenting or confirming the colon, procedures aimed at specifically presenting or confirming the colon and small bowel, or procedures to present or confirm the entire GIT: esophagus, stomach, SB, and colon.

[0083] Figure 2 shows a block diagram of a system for analyzing medical images captured in vivo via CE procedures. The system generally includes a capsule system 210 configured to acquire GIT images and a computing system 300 (e.g., a local system and / or a cloud system) configured to process the captured images.

[0084] The capsule system 210 may include a swallowable CE imaging device 212 (e.g., a capsule) configured to capture images of the GIT as the CE imaging device 212 moves through the GIT. The images may be stored in the CE imaging device 212 and / or transmitted to a receiving device 214, typically including an antenna. In some capsule systems 210, the receiving device 214 may be positioned on the patient who has swallowed the CE imaging device 212, and may take the form of, for example, a belt worn by the patient or a patch fixed to the patient.

[0085] The capsule system 210 may be communicatively coupled to the computing system 300 and can communicate captured images to the computing system 300. The computing system 300 may process the received images using, among other technologies, image processing techniques, machine learning techniques, and / or signal processing techniques. The computing system 300 may include a local computing device local to the patient and / or the patient's treatment facility, a cloud computing platform provided by a cloud service, or a combination of a local computing device and a cloud computing platform.

[0086] If the computing system 300 includes a cloud computing platform, images captured by the capsule system 210 can be transmitted online to the cloud computing platform. In various embodiments, images can be transmitted via a receiving device 214 worn or carried by the patient. In various embodiments, images can be transmitted via the patient's smartphone or via any other device connected to the internet and which can be coupled with the CE imaging device 212 or the receiving device 214.

[0087] Figure 3 shows a block diagram of an exemplary computing system 300 that may be used with the image analysis system of the present disclosure. The computing system 300 may include a processor or controller 305, which may be or include, one or more central processing units (CPUs), one or more graphics processing units (GPUs or GPGPUs), chips or any suitable computing or computing device, an operating system 215, memory 320, storage devices 330, input devices 335, and output devices 340. A module or device (e.g., a workstation) that collects or receives (e.g., a receiver worn by the patient) or displays or selects medical images collected by the CE imaging device 212 (Figure 2) may be, include, or be executed by the computing system 300 shown in Figure 3. The communication component 322 of the computing system 300 may enable communication with remote or external devices, for example, via the Internet or another network, via wireless, or via a suitable network protocol such as File Transfer Protocol (FTP).

[0088] The computing system 300 may include, or may include, any code segment designed and / or configured to perform tasks such as coordinating, scheduling, arbitrating, supervising, controlling, or managing the operation of the computing system 300, including scheduling the execution of programs. The memory 320 may be, or may include, random access memory (RAM), read-only memory (ROM), dynamic RAM (DRAM), synchronous DRAM (SD-RAM), double data rate (DDR) memory chips, flash memory, volatile memory, non-volatile memory, cache memory, buffers, short-term memory devices, long-term memory devices, or other suitable memory devices or storage devices. The memory 320 may be, or may include, multiple memory devices, possibly different memory devices. The memory 320 may store, for example, instructions for executing methods (e.g., executable code 325), and / or data such as user responses, interrupts, etc.

[0089] The executable code 325 may be any executable code, such as an application, program, process, task, or script. The executable code 325 may optionally be executed by the controller 305 under the control of the operating system 315. For example, once the executable code 325 is executed, it may be displayed or selected for the display of medical images as described herein. In some systems, two or more computing systems 300 or components of computing system 300 may be used for several functions described herein. One or more computing systems 300 or components of computing system 300 may be used for various modules and functions described herein. Devices containing components similar to or different from those included in computing system 300 may be used, connected to a network, and used as a system. One or more processors 305 may be configured to perform embodiments of the present invention, for example, by executing software or code. The storage device 330 may be, for example, a hard disk drive, a floppy disk drive, a compact disk (CD) drive, a writable CD (CD-Recordable, CD-R) drive, a universal serial bus (USB) device, or other suitable removable and / or fixed storage device, or may include them. Data such as instructions, codes, medical images, and image streams may be stored in the storage device 330, loaded from the storage device 330 into memory 320, and processed by the controller 305. In some embodiments, some of the components shown in Figure 3 may be omitted.

[0090] The input device 335 may be, for example, a mouse, keyboard, touchscreen or pad, or any other suitable input device, or may include them. It will be recognized that any number of suitable input devices may be operationally connected to the computing system 300. The output device 340 may include one or more monitors, screens, display devices, speakers, and / or any other suitable output devices. It will be recognized that any number of suitable output devices may be operationally connected to the computing system 300, as shown in block 340. Any applicable input / output (I / O) device may be connected to the computing system 300, for example, a wired or wireless network interface card (NIC), a modem, a printer, or a facsimile machine, and Universal Serial Bus (USB) devices or external hard drives may be included in input device 335 and / or output device 340.

[0091] Multiple computer systems 300, including some or all of the components shown in Figure 3, may be used in conjunction with the described system and method. For example, the CE imaging device 212, receiver, cloud-based system, and / or workstation or portable computing device for displaying images may include some or all of the components of the computer system in Figure 3. A cloud platform (e.g., a remote server) including components such as the computing system 300 in Figure 3 may receive, process and generate, and display (e.g., on a web browser running on a workstation or portable computer) the investigation data, including images and metadata. The “on-premise” option may use a medical facility workstation or local server to store, process, and display images and / or investigations.

[0092] According to some embodiments of this disclosure, a user, for example, a physician, may build an understanding of a case by reviewing a display of images, for example, automatically selected (e.g., captured by the CE imaging device 212), as images that may be relevant. According to some systems of this disclosure, a relatively small number of images from the captured images are displayed for each case for the user's review. "Relatively small number" means at most or at least on average about several hundred images, in contrast to current methods that typically display a video stream of images containing thousands of images (e.g., about 6,000 images) per case. In some systems, only up to several hundred images are displayed for the user's review. In some systems, the number of images displayed for the user's review is up to about 1,000. Browsing a relatively small number of still images, in contrast to browsing or reviewing a video stream of thousands of images, can greatly simplify the user's review process, reduce the reading time per case, and lead to better diagnoses. Exemplary user interface configurations for displaying the study are described in concurrently pending international patent application publication WO / 2020 / 079696, entitled "Systems and Methods for Generating and Displaying a Study of a Stream of In-Vivo Images," which is incorporated herein by reference in its entirety. Other configurations of the computing system 300 and the capsule system (210, Figure 2) are described in concurrently pending U.S. provisional patent application 62 / 867,050, entitled "Systems and Methods For Capsule Endoscopy Procedure," which is incorporated herein by reference in its entirety.

[0093] Referring to Figure 4, a diagram of the colon 400 is shown. The colon 400 absorbs water, and the remaining waste is stored as feces before being removed by defecation. The colon 400 can be divided into, for example, five anatomical divisions: the cecum 404, the right or ascending colon 410, the transverse colon 416, the left or descending colon 422 (e.g., the left colon - sigmoid colon 424), and the rectum 428.

[0094] The ileum 408 is the last part of the small intestine, leading to the cecum 404, which is separated from the cecum 404 by a muscular flap called the ileocecal valve (ICV) 406. The cecum 404 is the first part of the colon 400. The cecum 404 contains the appendix 402. The next part of the colon 400 is the ascending colon 410. The ascending colon 410 is connected to the small intestine by the cecum 404. The ascending colon 410 extends upward through the abdominal cavity toward the transverse colon 416.

[0095] The transverse colon 416 is a portion of the colon 400, extending from the hepatic flexure 414 (also known as the right colic flexure 414, a bend in the colon 400 due to the liver) to the splenic flexure 418 (also known as the left colic flexure 418, a bend in the colon 400 due to the spleen). The transverse colon 416 hangs down from the stomach and is attached to the stomach by a large fold of peritoneum called the greater omentum. Posteriorly, the transverse colon 416 is connected to the posterior abdominal wall by a mesentery known as the transverse mesentery.

[0096] The descending colon 422 is the portion of the colon 400 from the left colic flexure 418 to the beginning of the sigmoid colon 426. One function of the descending colon 422 in the digestive system is to store feces that will be expelled into the rectum. The descending colon 422 is also called the distal colon because it is further along the digestive tract than the proximal colon. The intestinal flora is generally very dense in this region. The sigmoid colon 426 is the portion of the colon 400 behind the descending colon 422 and in front of the rectum 428. The name sigmoid means S-shaped. The wall of the sigmoid colon 426 is muscular and contracts to increase pressure within the colon 400, moving feces into the rectum 428. The sigmoid colon 426 is supplied with blood from several branches (usually 2 to 6) of the sigmoid artery.

[0097] The rectum 428 is the final part of the colon 400. The rectum 428 holds the formed feces and awaits elimination through defecation.

[0098] The CE imaging device 212 (Figure 2) may be used to image the inside of the colon 400. Entry from the small intestine into the colon 400 occurs through the ICV 406. Typically, after entering the colon 400 via the ICV 406, the CE imaging device 212 enters the cecum 404. However, in some cases, the CE imaging device 212 loses track of the cecum 404 and proceeds directly into the ascending colon 410. The colon 400 may be wide enough to allow the movement of the CE imaging device 212 with little restriction. The CE imaging device 212 can rotate and roll. The CE imaging device 212 may remain stationary in one place for a long period of time, or it may move very quickly through the colon 400.

[0099] In general, segmentation of the GIT into anatomical segments may be based, for example, on the identification of the CE imaging device 212 through different anatomical segments. Such identification may be based, for example, on machine learning techniques. Segmentation of GIT images by the GIT segments in which images are captured is addressed in concurrently pending U.S. Provisional Patent Application No. 63 / 018,890, and segmentation of colon images by the colon segments in which images are captured is addressed in concurrently pending U.S. Provisional Patent Application No. 63 / 018,878. The entire contents of each of the above applications are incorporated herein by reference. Other techniques for segmenting GIT images by the GIT segments or colon segments in which images are captured will be understood by those skilled in the art.

[0100] The following description relates to images of the colon captured by a capsule endoscopy device. Such colon images may be part of a stream of GIT images, and may be extracted from the GIT image stream using the technology of the concurrently pending application, or using other methodologies that a person skilled in the art would understand.

[0101] Referring to Figure 5, a block diagram of a deep learning neural network 500 for providing classification scores for images is shown. Image 502 is a colon image. In this disclosure, the terms “classification score” or “score” may be used to describe values ​​or vectors of values ​​generated by a machine learning system / model for categories or sets of categories applicable to an image / frame. The terms “classification probability” or “probability” may be used to describe the conversion of the classification score to values ​​that reflect the probability that each category in the set of categories is applicable to an image / frame.

[0102] In some systems, deep learning neural networks 500 may include convolutional neural networks (CNNs) and / or recurrent neural networks with “long short-term memory” (LSTM), which will be discussed in more detail later in this specification. In machine learning, CNNs are the most commonly used class of artificial neural networks for analyzing images. The convolutional aspect of a CNN concerns applying matrix operations (called “kernels” or “filters”) to local parts of an image. The kernels / filters are computationally tuned during supervised training of the CNN to identify characteristics of the input image that can be used to classify the image. A CNN typically includes convolutional layers, activation function layers, and pooling (typically max pooling) layers to reduce dimensionality without losing too much information.

[0103] The deep learning neural network 500 can use one or more CNNs to provide classification scores for one or more colon images taken by the CE imaging device 212 (see Figure 2) regarding the presence of one or more markers, colonic characteristics, colonic conditions, or colonic contents (e.g., air bubbles). For example, the deep learning neural network 500 can generate classification scores for images regarding the presence of a colonic polyp 510, the presence of an ileocecal valve 512, the presence of a hemorrhoidal venous plexus 514, or other markers, features, conditions, or contents 516 (e.g., colonic bleeding). The deep learning neural network 500 can be run on a computing system 300 (Figure 3). Those skilled in the art will understand the deep learning neural network 500 and how to implement it. Various deep learning neural networks, including but not limited to MobileNet or Inception, can be used.

[0104] The deep learning neural network 500 can be trained on labeled training images. For example, the images may have labels 504 indicating the presence of landmarks, pathologies, features, or content, such as the presence of a colon polyp, an ileocecal valve, or a hemorrhoidal venous plexus. Labels 504 are indicated by dashed lines to show that they are used only for training the deep learning neural network 500 and not for inference outside of training, i.e., when operating the deep learning neural network 500. Training may include expanding the training images, including adding noise, changing colors, hiding parts of the training images, scaling the training images, rotating the training images, mirror-flipping the training images, and / or stretching the training images. Those skilled in the art will understand how to train the deep learning neural network 500 and how to carry out the training.

[0105] The exemplary embodiment of providing classification scores shown in Figure 5 is illustrative, and other methods for providing classification scores are also considered to be within the scope of this disclosure. For example, two or more deep learning neural networks (not shown) may operate to provide classification scores 510-516 for a colon image 502. For example, one deep learning neural network may be configured to provide a classification score for the presence of a polyp 510, another deep learning neural network may be configured to provide a classification score for the presence of an ileocecal valve 512, and a third deep learning neural network may be configured to provide a classification score for the presence of a hemorrhoidal venous plexus 514. The classification scores 510-516 may be provided by two or more deep learning neural networks with different configurations.

[0106] As another example, in various embodiments, unsupervised learning or other types of learning may be used. In various embodiments, classification scores may be provided by various configurations of neural networks, by non-neuronal machine learning systems (e.g., classical machine learning systems with feature selection), and / or by classification techniques that a person skilled in the art would recognize. In various embodiments, the machine learning system or classification system may provide classification probabilities, or in addition to, classification scores. In various embodiments, classification scores may be converted to classification probabilities using techniques such as Platt scaling, SoftMax, or other techniques that a person skilled in the art would recognize. Such variations are intended to be within the scope of this disclosure.

[0107] Referring to Figure 6, an exemplary flowchart of the operation for identifying images containing polyps is shown. The operation in Figure 6 can be performed by a computing system such as the computing systems in Figures 2 and 3. Some or all of the blocks in Figure 6 may be referred to as the polyp detection system. In block 610, the operation accesses various colon images captured by a capsule endoscopy device such as the CE imaging device 212 in Figure 2. In block 620, an initial image selection process is applied to the colon images, and various images are selected as seed images. The selection process accesses polyp presence scores or probabilities 622, such as scores / probabilities, provided by the deep learning neural network in Figure 5.

[0108] Generally, the seed image selection process 620 selects the image with the highest polyp presence score, and this selection can be carried out in various ways. Exemplary selection processes are described in International Patent Publication WO2017199258 and U.S. Provisional Patent Application 63 / 018,870, which are incorporated herein by reference in their entirety and can be applied to the initial selection process of block 620. For example, in brief, the initial selection process can be an iterative process. In each iteration, the process selects the image with the highest score / probability for polyp presence, and the selected image is referred herein to as the “seed image”. The scores / probabilities of images surrounding the seed image are reduced to decrease the likelihood that images of the same polyp will be selected in subsequent iterations. This process is repeated until one or more termination criteria are met. For example, the iterative image selection process can be terminated when the remaining image scores do not meet a score / probability threshold. As another example, the iterative image selection process can be terminated when a certain number of seed images have been selected, such as 60 seed images or 100 seed images. Figure 7 shows the results of an iterative selection process in a graph where the x-axis represents the image index / ID number and the y-axis represents the polyp presence score of the image. Images selected by the iterative process are indicated by circles at the top of the graph. The result of the initial image selection process 620 is a set of seed images with a high polyp presence score or probability. As stated above, the described image selection process is exemplary, and other image selection methods and techniques are considered to be within the scope of this disclosure.

[0109] The result of block 620 is a seed image with a high polyp presence score or probability. The operation of blocks 630–650 is described below, and such blocks may operate based on a trade-off between sensitivity and specificity that will be understood by those skilled in the art. In the operation of block 620, emphasis can be placed on sensitivity, even if it is necessary to reduce specificity. In the operation of blocks 630–650, emphasis can be placed on specificity, even if it is necessary to reduce sensitivity.

[0110] Continuing to refer to Figure 6, in block 630, the seed images obtained from the initial image selection process are processed by negative and / or positive filters. As used herein, a positive filter is the operation of positively designating seed images that meet one or more criteria as seed images containing polyps. A negative filter, on the other hand, is the operation of identifying seed images that meet one or more criteria as seed images that should not be positively designated as containing polyps. In various embodiments, the negative filter does not designate seed images as polyp-free. In various embodiments, the negative filter may designate seed images as polyp-free. Block 630 can have one or more positive filters and / or one or more negative filters applied, which will be described in more detail later herein. It is sufficient to note here that various filters may use scores or probabilities 632, such as classification scores or probabilities provided by the deep learning neural network in Figure 5. Furthermore, various filters may use image tracks 634, which will be described in relation to Figures 10 and 11. The filters may be implemented, in particular, using heuristics or machine learning systems such as deep learning neural networks or classical machine learning systems. The results of block 630 may include seed images designated by the positive filter as seed images containing polyps, seed images identified by the negative filter, and seed images that are neither designated by the positive filter nor identified by the negative filter. The last group of seed images that are neither designated by the positive filter nor identified by the negative filter are referred to herein as “unfiltered” seed images. Unfiltered seed images are processed by block 640.

[0111] In block 640, the unfiltered seed image obtained from block 630 is processed by a machine learning system that operates to provide a classification score or probability indicating whether the unfiltered seed image contains polyps or does not contain polyps. The machine learning system accesses input features 642 associated with the unfiltered seed image, which will be described in more detail later herein. In various embodiments, the machine learning system may be a classical machine learning system and may be trained by supervised learning, unsupervised learning, or other types of learning. In various embodiments, the machine learning system may be a soft-margin polynomial support vector machine of degree n, the degree may be quadratic, cubic, or other degrees. As described above, the output of the machine learning system is a classification score or probability indicating whether the unfiltered seed image contains polyps or does not contain polyps. Those skilled in the art will understand how to implement such a machine learning system and how to train such a machine learning system based on input features.

[0112] In block 650, the process identifies images with high confidence that contain polyps, based on classification scores or probabilities provided by the machine learning system. Various thresholds can be applied to the classification scores or probabilities. For example, in various embodiments, images with a classification probability of over 99% that contain polyps may be selected in block 650. The results of block 650 are images that were not designated by the positive filter as containing polyps, but have high confidence that contain polyps based on the machine learning classification score or probability. Such images selected by block 650 can be used in various ways as described herein. In various embodiments, images designated by the positive filter in block 630 as containing polyps can also be used in various ways as described herein.

[0113] The operation in Figure 6 is illustrative, and variations are intended to be within the scope of this disclosure. For example, in various embodiments, the process does not need to perform blocks 640 and 650, and instead may terminate at block 630, as shown in Figure 8. In the embodiment of Figure 8, the result of block 630 may be seed images designated by the positive filter as containing polyps and / or unfiltered seed images. As another variation of Figure 6, in various embodiments, block 630 may not be performed, as shown in Figure 9. In the embodiment of Figure 9, the machine learning system is applied to all seed images 640 and accesses input features associated with seed image 642. Such and other variations are intended to be within the scope of this disclosure.

[0114] The following describes various positive and negative filters that may be applied in block 630 of Figures 6 and 8.

[0115] As shown in Figures 6 and 8, various filters access and use the image track of the seed image 632. As used herein, “track” refers to a set of sequential images in which a polyp in the seed image is tracked by a sequential image tracker. As stated above, the term “sequential image” means images adjacent to each other in a sequence when ordered in that sequence. “Sequential image tracker” refers to an object tracking technique designed to identify small changes in an object between sequential images / frames and to be able to identify whether nearby seed images may contain the same polyp. Such tracking techniques include, for example, optical flow techniques. Those skilled in the art will understand how to implement optical flow techniques. Other techniques for tracking objects in sequential images are considered to be within the scope of this disclosure.

[0116] Figure 10 shows an example of applying a sequential image tracker to a seed image to identify a track relative to the seed image. Starting with seed image 1010, the sequential image tracker processes adjacent images to track polyp 1012. In the illustrated example, polyp 1012 is tracked over five frames prior to seed image 1010 and over three frames after seed image 1010. In the fourth frame 1020 after seed image 1010, the tracking technique terminates. The graphic representation of the tracking technique 1030 shows that the predicted position 1032 of the polyp is offset from the actual position 1034 of the polyp. Therefore, polyp 1012 was not tracked in that frame 1020. The track for seed image 1010 is the set of sequential frames (without frame 1020) in Figure 10 in which polyp 1012 in seed image 1010 was tracked by the sequential image tracker. The track includes seed image 1010. Therefore, in Figures 6 and 8, a track is accessed for each seed image 632, and the track can be used by various positive and / or negative filters. The embodiment in Figure 10 is illustrative. In various embodiments, the “track” can be identified using other techniques for comparing two images, such as the technique for comparing two images using the classification system described in concurrently pending U.S. Provisional Patent Application No. 63 / 073,544, filed September 2, 2020. Such provisional applications are incorporated herein by reference in their entirety.

[0117] As described above, a positive filter is the operation of positively designating seed images that meet one or more criteria as seed images containing polyps. According to aspects of this disclosure, a positive filter may have a criterion that seed images having a polyp presence score or probability of 622 that is above a threshold are designated as seed images containing polyps. In various embodiments, the polyp presence score may be normalized to a value between 0 and 1. The polyp presence probability is, of course, between 0 and 1. In various embodiments, the threshold may be 0.999999 or 0.9999999, or another value that provides a high probability that the seed image contains a polyp.

[0118] In various embodiments, the positive filter may have a further criterion that the seed image track contains at least a certain number of consecutive images whose polyp presence score or probability is greater than or equal to a threshold. In various embodiments, the thresholds for the seed image and the images in the track may be the same value. In various embodiments, the thresholds for the seed image and the images in the track may be different values. As an example, the positive filter may designate a seed image as containing a polyp if the seed image has a polyp presence score / probability of at least 0.99999 and at least five consecutive frames adjacent to the seed image also have a polyp presence score / probability of at least 0.9999. Figure 11 shows an example of such a seed image and track, where the seed image is identified by frame number 171571. The seed image has a polyp presence score of 0.99999, and the five consecutive frames adjacent to the seed image have a polyp presence score of at least 0.9999. Therefore, the seed image in Figure 11 is designated by the positive filter as containing a polyp.

[0119] The positive filters described above are illustrative. Other positive filters for positively designating an image as containing a polyp are considered to be within the scope of this disclosure. For example, track information may be used in other ways to form a positive filter. As described above, a track comprises a collection of images, such images are captured over time by a capsule endoscopy device (e.g., 212 in Figure 2). Information of a temporal nature can be processed using long-short-term memory (LSTM). A deep learning neural network, such as the deep learning neural network 500 in Figure 5, may be configured to receive image tracks as input. The deep learning neural network may be trained to give a classification score or probability for a seed image based on the image tracks received by the deep learning neural network. The classification score or probability may be, for example, a score of the probability that the seed image contains a polyp.

[0120] As described above, the negative filter is the operation of identifying seed images that meet one or more criteria as seed images that should not be actively designated as containing polyps. In various embodiments, the negative filter does not designate seed images as polyp-free. In various embodiments, the negative filter may designate seed images as polyp-free.

[0121] As shown in Figures 6 and 8, the negative filter can access classification scores or probabilities 632, such as the classification score or probability provided by the machine learning system in Figure 5. According to aspects of this disclosure, the negative filter can access ileocecal valve (ICV) presence scores or probabilities (e.g., 512, Figure 5) and can operate to identify seed images that have ICV scores or probabilities above a threshold, such as an ICV probability above 0.99999 or above another threshold. The ileocecal valve is an anatomical landmark in the transition from the small intestine to the colon and may resemble a large colon polyp in appearance, so that the seed image may have a sufficiently high polyp presence score or probability for being a seed image, while also having an ICV presence score above a predetermined threshold. Such seed images can be identified by the negative filter as meeting the criteria. The negative filter can specify that a seed image does not contain polyps.

[0122] According to aspects of this disclosure, a negative filter can access the presence score or probability of hemorrhoidal venous plexus (e.g., 514, Figure 5). Hemorrhoidal venous plexus is an anatomical landmark surrounding the rectum at the end of the large intestine and may resemble colonic polyps in appearance. In various embodiments, the negative filter can operate to identify seed images that have hemorrhoidal venous scores or probabilities above a threshold, such as a hemorrhoidal venous probability above 0.99999 or above another threshold. A seed image may have a sufficiently high polyp presence score or probability to be a seed image, while also having a hemorrhoidal venous plexus presence score above a predetermined threshold. Such seed images can be identified by the negative filter as meeting the criteria. The negative filter can specify a seed image as polyp-free.

[0123] In various embodiments, instead of accessing a hemorrhoid venous plexus presence score or probability, the negative filter may instead operate to determine the proximity of a seed image to a body exit / gastrointestinal exit. The proximity of a seed image to a body exit can be determined in various ways. For example, the negative filter may access a colon image (e.g., the colon image accessed in block 610 of Figure 6) and determine the proximity of the seed image to a body exit by whether the seed image is within the final portion of the colon image, for example, whether the seed image is within the final 0.5% of the colon image or within another final percentage of the colon image. If the seed image is within the final portion of the colon image, the negative filter may identify the seed image as meeting the criteria. In various embodiments, the negative filter may specify a seed image as not containing polyps. In various embodiments, the negative filter may identify a seed image as meeting the criteria, but may not specify a seed image as not containing polyps.

[0124] According to aspects of this disclosure, a negative filter can access an image track for a seed image, such as the image track described in relation to Figure 10. The negative filter may have a criterion for identifying a seed image when the seed image is the only image in the track that has a polyp presence score or probability above a threshold. For example, if the seed image in an image track has a polyp presence probability of at least 0.998 and all other images in the image track have a polyp presence probability of less than 0.998, the seed image can be identified as meeting the criterion. Other thresholds may also be used. In various embodiments, the negative filter may specify a seed image as polyp-free. In various embodiments, the negative filter may identify a seed image as meeting the criterion, but may not specify a seed image as polyp-free.

[0125] According to aspects of this disclosure, a negative filter can access the estimated polyp size of a seed image. The negative filter may have criteria for identifying a seed image when the estimated polyp size of the seed image is below a threshold, such as when the estimated polyp size is less than 3.5 mm or below another threshold. Various techniques can be used to generate the estimated polyp size accessed by the negative filter. An example of such a technique is disclosed in concurrently pending U.S. Patent Application No. A0004997US01 (2851-17 PRO), which is incorporated herein by reference in its entirety. Other techniques for estimating the polyp size of polyps in an image will be understood by those skilled in the art. Such and other variations are intended to be within the scope of this disclosure.

[0126] Accordingly, various positive and negative filters have been described above. Such filters may be applied in block 630 in Figures 6 and 8. In the operation of Figure 6, seed images that are not specified by the positive filter and are not identified by the negative filter (i.e., unfiltered seed images) can be processed by the machine learning system in block 640 as described above. In the operation of Figure 8, block 630 is the end of the operation and can provide seed images specified by the positive filter, and in some embodiments, can also provide unfiltered seed images.

[0127] The following describes exemplary input features for a machine learning system, accessed in block 642 of Figures 6 and 9. As described above, the machine learning system operates based on the input features to provide a classification score or probability indicating whether an unfiltered seed image contains polyps or does not. In various embodiments, the machine learning system may be a soft-margin polynomial support vector machine of degree n. In various embodiments, the machine learning system may be based on other classical machine learning models, such as decision trees, naive Bayes, or logistic regression, among others, as will be recognized by those skilled in the art. As described below, some input features may be based on image tracks of the seed image, such as the image tracks shown in Figures 10 and 11.

[0128] According to aspects of this disclosure, one of the input features to the machine learning system may be a seed polyp score / probability provided by a polyp detector, such as the detector shown in Figure 5.

[0129] According to aspects of this disclosure, one of the input features to a machine learning system may be a seed polyp score / probability determined based on a vote or calculation on a polyp score / probability provided by an ensemble of polyp detectors (e.g., Figure 5) whose input is an image and whose output is the probability that the image contains a polyp. For example, the seed polyp score may be the mean of the polyp scores / probabilities provided by the ensemble of polyp detectors, or may be provided by another calculation such as the median in particular.

[0130] According to aspects of this disclosure, one of the input features to the machine learning system may be the number of images in an image track for a seed image, which may be called the track length.

[0131] According to aspects of this disclosure, one of the input features to the machine learning system may be the number of images in the image track of a seed image that have a polyp presence score or probability greater than a threshold, such as a polyp presence probability greater than 0.998 or greater than another threshold.

[0132] According to aspects of this disclosure, one of the input features to the machine learning system may be the difference in image index / ID numbers between the index / ID number of the seed image and the index / ID number of the colon beginning image. In various embodiments, the colon beginning image may be an ICV image. The colon beginning image can be determined in various ways. For example, the ICV image can be determined using an ICV presence score or probability (e.g., 512, Figure 5). As another example, as described above, segmentation of a GIT image by the GIT portion in which the image is captured is addressed in concurrently pending U.S. Provisional Patent Application No. 63 / 018,890, and segmentation of a colon image by the colon portion in which the image is captured is addressed in concurrently pending U.S. Provisional Patent Application No. 63 / 018,878. Such techniques for segmenting a GIT image can be used to identify the colon beginning image. Other techniques for identifying the colon beginning image are considered to be within the scope of this disclosure.

[0133] According to aspects of this disclosure, one of the input features to a machine learning system may be localization information (represented as a number) relating to the colonic segment in which the seed image was captured. As illustrated in relation to Figure 4, the colon 400 includes five anatomical segments: the cecum, the right or ascending colon, the transverse colon, the left or descending colon, and the rectum. Each of these five segments can be numbered from 1 to 5. The segment number of the colonic segment in which the seed image was captured may be an input feature to a machine learning system. As stated above, segmentation of a colonic image by the colonic segment in which the image was captured is addressed in concurrently pending U.S. Provisional Patent Application No. 63 / 018,878. Such techniques for segmenting a colonic image by the colonic segment in which the image was captured can be used to identify the number of the colonic segment in which the seed image was captured. Other techniques for identifying the number of the colonic segment in which the seed image was captured will be understood by those skilled in the art and are intended to be within the scope of this disclosure.

[0134] Accordingly, various input features for input to a machine learning system have been described. Those skilled in the art will understand how to train and implement a machine learning system based on such input features. In various embodiments, not all of the described input features must be used, and various combinations of input features may be used. In various embodiments, all of the described input features may be used. Some or all of the input features can be normalized in various ways. The described input features are illustrative, and other input features are also considered to be within the scope of this disclosure.

[0135] Referring again to Figures 6 and 8, the machine learning system in block 640 processes the input features and provides a classification score or probability indicating whether each seed image contains a polyp or not. The classification probabilities can be used directly to determine which seed images have a sufficiently high probability of being selected as seed images containing polyps. The classification scores can be converted into classification probabilities in various ways, such as Platt scaling, SoftMax, or other techniques recognized by those skilled in the art. Seed images designated as containing polyps can be used in various ways, as described below in relation to Figure 12.

[0136] Depending on the aspects of this disclosure, the operation of Figures 6, 8, and 9 may be extended in various ways. For example, additional rules based on polyp size estimation (e.g., adjusted polyp detector score thresholds) may be added to comply with local medical guidelines / treatments / policies related to polyp size. For example, US medical practice is often based on at least one polyp above a certain size, while European medical practice is often based on multiple polyps of arbitrary sizes. Other countries may have different medical practices, and additional rules may be adapted to the medical practices of a particular country.

[0137] Therefore, the above description provides a system and method for identifying images containing polyps with high reliability. The following describes an illustrative use of the identified images.

[0138] Referring here to Figure 12, an exemplary display screen for presenting images of polyps to a clinician is shown. A GUI (or survey viewing application) can be used to display the survey for the user's review and to generate a survey report (or CE action report). The screen in Figure 12 displays a set of still images included in the survey. The images may be, for example, seed images selected in block 620 of Figure 6, Figure 8, or Figure 9. The user can review the images and select one or more images of interest, for example, to display one or more polyps. The survey images are displayed according to their location in the colon. This location may be any one of the following five anatomical colonic segments: cecum, ascending, transverse, descending sigmoid colon, and rectum. The screen shows a survey image identified as located in the descending-sigmoid colon. The user can switch the display of images located in different segments. The illustrated display screen may be used by a user, for example, a clinician, to select images to be included in the survey report. In some embodiments, the survey may also include tracks associated with seed images (i.e., survey seed images). In such cases, the user may request (via user input) to display the track associated with the displayed image (not shown). By reviewing the associated track, the clinician may receive further information about the seed image that can assist the clinician in determining whether the seed image (or optionally any other track image) is of interest.

[0139] Continuing to refer to Figure 12, a clinician can add bounding boxes around polyps observed in an image. Bounding boxes 1210 added by the user can be displayed in a specific color, such as green or another color. According to aspects of this disclosure, an image containing a polyp identified by the system and method of this disclosure can be presented to a clinician, and bounding boxes 1220 can be automatically added to such an image to indicate the location of the polyp. Bounding boxes 1220 added by the system and method of this disclosure can be displayed in a different color from bounding boxes added by the user, such as red or another color. In this way, the user can easily see which bounding boxes were added by the user and which were added automatically.

[0140] Referring here to Figure 13, an exemplary display screen for suggesting images of polyps to a clinician is shown. The display screen shows images 1310, 1312 that the clinician has selected as containing polyps and that the clinician wishes to include in the final capsule endoscopy procedure report. Before the clinician confirms their selection, the systems and methods of the present disclosure may display suggested images of polyps 1320 that the clinician may have missed or not selected. Suggested images 1320 may be images designated by a positive filter as containing polyps (e.g., block 630, Figures 6 and 8), or images selected in block 650 (Figures 6 and 9) as having a sufficiently high classification score or probability of containing polyps. In various embodiments, suggested images 1320 may also include unfiltered seed images. In various embodiments, the proposed images of polyps 1320 may be limited to GIT segments that do not include frames of polyps selected by the clinician, or they may be limited to GIT segments that include only smaller polyps (e.g., less than 6 mm) identified by the clinician. In various embodiments, if a GIT segment includes images of polyps selected by the clinician (e.g., 6 mm) and the system of the disclosure identifies images of smaller polyps (e.g., 5 mm), the system of the disclosure may not suggest the smaller polyps to the clinician. Thus, in various embodiments, images that provide additional clinical value (e.g., in accordance with medical practice guidelines) may be suggested, but images that do not provide additional clinical value may not be suggested.

[0141] Referring to Figure 14, an exemplary display screen that may be automatically generated by the systems and methods of this disclosure without human intervention or input is shown. In contrast to the display screen of Figure 13, which includes user-selected images 1310, 1312, the polyp images in Figure 14 can be automatically selected without human input. The automatically selected images may be images designated by a positive filter as images containing polyps (e.g., block 630, Figures 6 and 8), or images selected in block 650 (Figures 6 and 9) as having a sufficiently high classification score or probability of containing polyps. In various embodiments, the display screen may always display a page of all proposed polyps regardless of any clinician selection or decision, and such a display screen may be available to the user or clinician before or after the clinician reviews any images. In various embodiments, the automatic selection in Figure 14 may not select unfiltered seed images. In various embodiments, the systems and methods of this disclosure may skip the display screen shown in Figure 14 and automatically generate and finalize capsule endoscopy procedure reports without any input or intervention by a clinician.

[0142] Figures 12–14 illustrate possible uses of images selected by the processes of Figures 6, 8, and 9. The embodiments in Figures 12–14 are illustrative and do not limit the scope of this disclosure to such display screens. Other uses are also contemplated. In various embodiments, the systems and methods of this disclosure can be used to override decisions made by other tools in order to exclude CE treatments, such as the tools described in the concurrently pending U.S. Provisional Patent Application No. A0003746US01 (2851-7 PRO), which are incorporated herein by reference as a whole. Such tools provide a validity scale that indicates a measure of the effectiveness of a CE treatment in capturing a given event in a plurality of images. In various embodiments, the validity scale of the treatment is determined based on a feature scale, which may include a plurality of scales indicating the probability of at least one of capturing or not capturing a given event. Multiple measures may include (i) segmental validity probabilities based on multiplying at least two of the following: motor score, lavage level per segment, or transit time; (ii) overall validity measures based on at least one of the following: mean lavage score across all segments, patient demographics, the last segment of the GIT reached by the CE device, or the absolute time spent by the CE device in a segment of the GIT; and / or (iii) at least one of the following associated with images: anatomical colon segments, CE device transit patterns, CE device communication errors, anatomical landmarks in multiple images, or GIT tissue coverage in multiple images. Such and other uses are considered to be within the scope of this disclosure.

[0143] This disclosure provides a system and method for reliably identifying images of polyps, however, not all polyp occurrences may require follow-up. In particular, the size of the polyp is important in determining whether follow-up is necessary. If a polyp is sufficiently large, for example, at least 6 mm in size, clinicians generally want to examine the polyp by colonoscopy. According to aspects of this disclosure, the system and method can determine whether to recommend colonoscopy or whether to recommend follow-up for a specific number of months or years. Such decisions can be made by a computing system, such as the computing system shown in Figure 3.

[0144] Referring to Figures 15 and 16, a decision can be made based on the probability that at least one polyp with a size of 6 mm or larger is present. This decision uses images identified by the processes in Figures 6, 8, and 9, which may be seed images (block 630) designated by the positive filter as containing polyps, or seed images (blocks 640, 650) with a sufficiently high classification score or probability of containing polyps. Assuming there are n such images, P i (TP & size ≥ 6 [mm]) represents the probability that image i contains a polyp and that the polyp is at least 6 mm in size. This probability involves two factors: whether the image contains a polyp and whether the polyp is at least 6 mm in size. Assuming these two factors are independent, the probability can be expressed as follows: P i (TP & size ≥ 6 [mm]) = P i (TP)P i (Size ≥ 6 [mm]). P i (TP) represents the probability that image i contains a polyp. i(Size ≥ 6 [mm]) represents the probability that in image i, the size of the polyp is 6 mm or more. To determine whether to recommend a colonoscopy procedure, only one candidate image needs to have a sufficiently high probability of containing a polyp with a size of at least 6 mm.

[0145] FIG. 15 shows a graph that can be used to determine P i (TP). The x-axis represents the soft margin for a machine learning system such as the machine learning system in block 640 of FIGS. 6, 8, and 9. As those skilled in the art will understand, the term "soft margin" can refer to the continuous output of a classifier (e.g., a classical machine learning algorithm) related to the distance between an example and the separating hyperplane / classification boundary of the classifier. The soft margin can indicate the certainty that the machine learning system has correctly classified an image as containing a polyp. The higher the absolute value of the soft margin, the farther from the classification boundary and the more certain in its decision. The graph of FIG. 15 can be derived empirically by accessing the soft margin related to the labeled training set.

[0146] As an example, the x-axis of FIG. 15 can be divided into intervals of 0.1 or intervals of another size. For each soft margin interval, the number of training inputs corresponding to the presence of a polyp and having a soft margin within that interval can be counted, and the number of training inputs corresponding to the absence of a polyp and having a soft margin within that interval can be counted. Using the two counts, the percentage of inputs having a polyp and having a soft margin within that interval can be calculated empirically. The percentage can be used as a surrogate for the probability that an input has a polyp if its soft margin falls within the interval. An example of the result is shown in FIG. 15. Since the probability is determined empirically, it is quite noisy. A regression analysis can be performed to fit the curve 1502 to the empirical probability to provide a smoothed estimator 1502 for determining P i (TP). The embodiment described above with respect to FIG. 15 is exemplary, and other methods can be used for P iThis is intended to determine (TP).

[0147] Figure 16 shows P i A graph is shown that can be used to determine polyp size (size ≥ 6 [mm]). The x-axis represents the estimated polyp size determined for capsule endoscopy (CE) images. As described above, polyp size can be estimated in the form described in the concurrently pending U.S. Patent Application No. A0004997US01 (2851-17 PRO), or by other art as understood by those skilled in the art. Each training CE image with a known actual polyp size (e.g., at least 6 mm or less than 6 mm) can be processed to determine its estimated polyp size. The x-axis can be divided into estimated polyp size intervals, such as 0.1 mm intervals or intervals of another size. Training inputs with estimated polyp sizes that fall within an interval can be counted. The count in an interval can be used to calculate the percentage of training inputs with an actual polyp size of 6 mm or larger for that interval, and the empirical percentage can be used as a substitute for the probability that an input has a polyp of 6 mm or larger in that interval. An example of the results is shown in Figure 16. Since the probabilities are determined empirically, they are quite noisy. We performed regression analysis to fit curve 1602 to empirical probabilities and P based on the estimated polyp size. i A smoothing estimator 1602 can be provided for determining (size ≥ 6 [mm]). The embodiments described above with respect to Figure 16 are illustrative, and other methods can be provided. i This is intended to determine the size (≥ 6 [mm]).

[0148] As mentioned above, the probability that the seed image has a polyp and that the polyp is at least 6 mm is P i (TP)P i This can be determined by (size ≥ 6 [mm]). If any probability resulting from the calculation exceeds a threshold such as 0.999 or another threshold, the calculation can be determined to indicate the presence of an image of a polyp that is 6 mm or larger, and a colonoscopy can be recommended based on this.

[0149] The embodiments described for using 6 mm as the polyp size boundary can be applied to another polyp size boundary, such as 5 mm or 7 mm or another polyp size boundary.

[0150] The embodiments described above with respect to FIGS. 15 and 16 are exemplary. Other methods for determining whether to recommend a colonoscopy are contemplated. Such variations and other variations are intended to be within the scope of the present disclosure.

[0151] Referring to Figure 17, exemplary operations in which the systems and methods of Figures 15 and 16 can be used are shown. In block 1710, the operation includes accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device during CE treatment. Each image in the multiple images is suspected to contain a polyp and is associated with a probability of containing a polyp. In addition, the multiple images include seed images, each seed image is associated with one or more images from the multiple images, and one or more images associated with each seed image are identified as suspected to contain the same polyp as the associated seed image. In block 1720, the operation includes applying a polyp detection system to the seed images to identify seed images containing polyps. The polyp detection system is applied to each seed image in the multiple images based on one or more images associated with the seed image and the probabilities associated with the seed image and the one or more associated images. In block 1730, the operation includes identifying images in the multiple images that contain polyps of a certain size or larger. Each image in a group of images is further associated with the estimated size of a suspected polyp contained in each image, and the polyp detection system is further applied to each seed image of the seed image based on the estimated polyp size associated with the seed image and one or more images associated with the seed image. In block 1740, if at least one seed image is identified as containing a polyp of a certain size or larger, or a certain number of polyps of a certain size or larger, and the treatment is determined to be inappropriate and excluded, the operation includes disabling the exclusion of the treatment.

[0152] Regarding block 1740, as described above, the technology for determining that a treatment is inappropriate is disclosed in a co-pending U.S. provisional patent application having filing number A0003746US01(2851-7 PRO). Such a tool provides a validity measure indicating the effectiveness of a CE treatment in capturing a predetermined event in a plurality of images, as described above, and the validity measure of the treatment can be determined based on a feature measure that can include a plurality of measures indicating at least one probability of capturing or not capturing the predetermined event.

[0153] Continuing to refer to block 1740, the actions for invalidating the exclusion of a treatment can be based, among other things, on heuristics such as polyp detection probability and / or optionally a threshold of polyp size or minimum number of images. In various embodiments, the actions for invalidating can be based on a set of seed images (e.g., FIGS. 15 and 16), for example, based on the probability for each treatment of an image containing a polyp of at least a predetermined size. The actions of FIG. 17 are illustrative, and variations are intended to be within the scope of the present disclosure.

[0154] Therefore, the above description provides a system and method for identifying images containing polyps with a high degree of confidence and provides various uses for such identified images. The above figures and embodiments are illustrative and do not limit the scope of the present disclosure.

[0155] Although some embodiments of the present disclosure are shown in the drawings, the present disclosure should be considered to be as broad as is acceptable in the art and is intended to be read in the same manner, and thus the present disclosure is not intended to be limited to these embodiments. Therefore, the above description should not be construed as limiting, but rather as merely illustrative of particular embodiments. Other modifications that do not depart from the scope and spirit of the claims appended hereto will be apparent to those skilled in the art.

Claims

1. A system for recommending colonoscopy, wherein the system is One or more processors, At least one memory for storing instructions and Equipped with, When the instruction is executed by one or more processors, Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps. For each of the aforementioned multiple images, Applying a classical machine learning system configured to provide information indicating whether an image contains polyps or not, based on input features corresponding to the image, Accessing the soft margin of the classical machine learning system corresponding to the aforementioned image, Accessing a soft margin mapping to the probability that an image contains polyps, A determination to recommend colonoscopy without human intervention, the determination comprising: determining the probability that the multiple images contain polyps based on the soft margins of the multiple images and the mapping of the soft margins to the probability that the images contain polyps; comparing the probability that the multiple images contain polyps with a threshold; and determining, based on the comparison, whether to recommend colonoscopy. A system that causes the aforementioned system to perform the above action.

2. Furthermore, when the instruction is executed by one or more processors, For each of the aforementioned multiple images, access the estimated polyp size of the image. The method involves processing the estimated polyp size of the plurality of images to obtain the probability that the actual polyp size is at least a predetermined size, wherein the processing includes dividing the estimated polyp size into a plurality of intervals, calculating empirical probabilities for each interval from labeled training images having known actual sizes, and fitting a regression curve to smooth the empirical probabilities. The probability that the actual polyp size is at least a predetermined size is compared with a threshold. The system is made to perform the above action. The system according to claim 1, wherein the decision on whether to recommend a colonoscopy is further based on comparing the probability that the actual polyp size is at least a predetermined size with the threshold.

3. A computer-aided method for recommending colonoscopy, wherein the method is: Accessing multiple images of the gastrointestinal tract (GIT) captured by a capsule endoscopy device, wherein the multiple images may include polyps. For each of the aforementioned multiple images, Applying a classical machine learning system configured to provide information indicating whether an image contains polyps or not, based on input features corresponding to the image, Accessing the soft margin of the classical machine learning system corresponding to the aforementioned image, Accessing a soft margin mapping to the probability that an image contains polyps, A method for determining whether to recommend a colonoscopy based on the soft margins of the plurality of images without human intervention, the determination of which the plurality of images contain polyps based on the soft margins of the plurality of images and the mapping of the soft margins to the probability that the images contain polyps, the comparison of the probability that the plurality of images contain polyps with a threshold, and the determination of whether to recommend a colonoscopy based on the comparison. A computer implementation method, including

4. The computer implementation method is: For each of the aforementioned multiple images, access the estimated polyp size of the image, The method involves processing the estimated polyp size of the plurality of images to obtain the probability that the actual polyp size is at least a predetermined size, wherein the processing includes dividing the estimated polyp size into a plurality of intervals, calculating empirical probabilities for each interval from labeled training images having known actual sizes, and fitting a regression curve to smooth the empirical probabilities. The probability that the actual polyp size is at least a predetermined size is compared with a threshold. It further includes, The computer-assisted method according to claim 3, wherein the decision on whether to recommend a colonoscopy is further based on comparing the probability that the actual polyp size is at least a predetermined size with the threshold.

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