# Artificial Intelligence for the Management of Colorectal Neoplasia Using Combined-Modality Spectroscopy and Enhanced Imaging

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

Objectives: The overarching objective of this proposal is to develop, validate, and deploy an artificial
intelligence (AI)-based low-cost platform to make endoscopic prevention of colorectal cancer (CRC) more
efficient. We seek to leverage our work in spectroscopic biopsy tools and automated endoscopic imaging
interpretation to create an accurate and widely-adoptable, real-time histology (RTH) platform based on
combined optical modalities and machine learning. At present, colonoscopic CRC prevention hinges on
the complete removal and histopathological assessment of all polyps. This practice results in the removal
of large numbers of polyps that have negligible malignant potential. As such, there is a widely-recognized
need for simple, rapid, and low-cost methods for “smart” polyp assessment in real time to decrease biopsy
costs and risks. To this end, major professional societies, led by The American Society for Gastrointestinal
Endoscopy (ASGE), have endorsed the purely optical management of diminutive polyps and have put forth
guidelines and acceptable performance thresholds (i.e. the PIVI statements) for eventual adoption. The
past decade has seen an explosion in biophotonic technologies toward diagnosing and treating colorectal
neoplasia more precisely. While several PIVI thresholds for diminutive colonic polyps have been met,
prospective testing in non-academic settings has fallen short due to the barriers of operator skill and
experience. Recent advances in machine learning/artificial intelligence, and their application to endoscopic
imaging, have shown promise for automating RTH to overcome operator factors. Such capability would
finally open the door to widespread adoption of cost-saving resect-and-discard and leave-behind
paradigms for diminutive polyps. On this front, we will build on our work using elastic scattering
spectroscopy (ESS) biopsy tools, which has shown great promise for RTH, combining it with computer-
assisted diagnosis (CAD) of endoscopic images. We hypothesize that the novel combination of these
complementary AI based technologies will lead to a highly-accurate, minimally-disruptive, and widely-
deployable approach for RTH of colorectal polyps. The specific aims for the present project are: 1. Develop
AI models for computer assisted RTH based on spectroscopy and endoscopic images; 2. Implement
system enhancements and tool design for multisite deployment; 3. Perform a multisite clinical study using
AI-based RTH based on the combination of ESS and CAD of endoscopic images.
Methodology: First, we will conduct a clinical study at VA Boston in which we will collect ESS
measurements and endoscopic images of polyps at colonoscopy. We will use this paired data, correlated
to clinical features and histopathology to design and validate AI algorithms for computer assisted RTH of
colorectal polyps (including serrated lesions) that utilize both sources of optical information. Concurrently,
we will prototype and build the next-genera...

## Key facts

- **NIH application ID:** 10075123
- **Project number:** 5I01CX001146-06
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** SATISH K SINGH
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2015-07-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10075123

## Citation

> US National Institutes of Health, RePORTER application 10075123, Artificial Intelligence for the Management of Colorectal Neoplasia Using Combined-Modality Spectroscopy and Enhanced Imaging (5I01CX001146-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10075123. Licensed CC0.

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