Edge Artificial Intelligence Device in Real-Time Endoscopy for the Classification of Colonic Neoplasms

Objective: Although prior research developed an artificial intelligence (AI)-based classification system predicting colorectal lesion histology, the heavy computational demands limited its practical application. Recent advancements in medical AI emphasize decentralized architectures using edge computing devices, enhancing accessibility and real-time performance. This study aims to construct and evaluate a deep learning-based colonoscopy image classification model for automatic histologic categorization for real-time use on edge computing hardware. Design: We retrospectively collected 2418 colonoscopic images, subsequently dividing them into training, validation, and internal test datasets at a ratio of 8:1:1. Primary evaluation metrics included (1) classification accuracy across four histologic categories (advanced colorectal cancer, early cancer/high-grade dysplasia, tubular adenoma, and nonneoplasm) and (2) binary classification accuracy differentiating neoplastic from nonneoplastic lesions. Additionally, an external test was conducted using an independent dataset of 269 colonoscopic images. Results: For the internal-test dataset, the model achieved an accuracy of 83.5% (95% confidence interval: 78.8-88.2%) for the four-category classification. In binary classification (neoplasm vs. nonneoplasm), accuracy improved significantly to 94.6% (91.8-97.4%). The external test demonstrated an accuracy of 82.9% (78.4-87.4%) in the four-category task and a notably higher accuracy of 95.5% (93.0-98.0%) for binary classification. The inference speed of lesion classification was notably rapid, ranging from 2-3 ms/frame in GPU mode to 5-6 ms/frame in CPU mode. During real-time colonoscopy examinations, expert endoscopists reported no noticeable latency or interference from AI model integration. Conclusions: This study successfully demonstrates the feasibility of a deep learning-powered colonoscopy image classification system designed for the rapid, real-time histologic categorization of colorectal lesions on edge computing platforms. This study highlights how nature-inspired frameworks can improve the diagnostic capacities of medical AI systems by aligning technological improvements with biomimetic concepts.