Neural Network-Based Histologic Remission Prediction In Ulcerative Colitis

BACKGROUND & AIMS: Histological remission (HR) is advocated and considered as a new therapeutic target in ulcerative colitis (UC). Diagnosis of histologic remission currently relies on biopsy; during this process, patients are at risk for bleeding, infection, and post-biopsy fibrosis. In addition, histologic response scoring is complex and time-consuming, and there is heterogeneity among pathologists. Endocytoscopy (EC) is a novel ultra-high magnification endoscopic technique that can provide excellent in vivo assessment of glands. Based on the EC technique, we propose a neural network model that can assess histological disease activity in UC using EC images to address the above issues. The experiment results demonstrate that the proposed method can assist patients in precise treatment and prognostic assessment. METHODS: We construct a neural network model for UC evaluation. A total of 5105 images of 154 intestinal segments from 87 patients undergoing EC treatment at a center in China between March 2022 and March 2023 are scored according to the Geboes score. Subsequently, 103 intestinal segments are used as the training set, 16 intestinal segments are used as the validation set for neural network training, and the remaining 35 intestinal segments are used as the test set to measure the model performance together with the validation set. RESULTS: By treating HR as a negative category and histologic activity as a positive category, the proposed neural network model can achieve an accuracy of 0.9, a specificity of 0.95, a sensitivity of 0.75, and an area under the curve (AUC) of 0.81. CONCLUSION: We develop a specific neural network model that can distinguish histologic remission/activity in EC images of UC, which helps to accelerate clinical histological diagnosis. keywords: ulcerative colitis; Endocytoscopy; Geboes score; neural network.