The document discusses developing an automated method for counting polyps during colonoscopies. It notes that accurately counting polyps is important for determining patient treatment but can be difficult for doctors to do manually within time constraints. Prior methods have been developed like software to document polyps in real time, but do not necessarily save time. The team aims to design a solution using video processing and a user-friendly interface to quickly and accurately count polyps to help doctors determine appropriate treatment.

1. Automated Polyp Counting During Colonoscopies
Rachael Meehan, Allison Porter, Kevin Knoemschild, Eno-Abasi Augustine-Akpan
Mentored by: Kendall Keck, M.D. (Research Resident/University of Iowa Hospitals and Clinics)
Initial Statement of Problem
During a colonoscopy, it is difficult for gastroenterologists to get an
accurate count of polyps within the time constraints of the procedure.
Background & Motivation
Millions of patients receive a colonoscopy
each year. One of the main factors for
determining treatment for these patients
is the number of polyps in the
colon and rectum.
Numerous diseases include the growth of polyps in the colon:
• Lynch Syndrome
• Familial Adenomatous Polyposis
• Gardner’s Syndrome
• MYH-Associated Polyposis
• Serrated Polyposis Syndrome
A great number of polyps drastically increases the chance of cancer
developing in the colon and/or rectum, making the ability to
accurately count these polyps important.
Population
Gastroenterologists that use colonoscopy footage to find colon
irregularities for diagnosis and prevention of disease.
Need Statement
A way to count polyps during a colonoscopy to provide
gastroenterologists with quantitative information to help determine
the most appropriate treatment option.
Functional Requirements
Anticipated Engineering Skills and Tools
• Image/video processing of pre-recorded video
• Good software design techniques including:
• Robust software that can be used across multiple systems
• A user friendly interface that is easy to use for any GI
specialist that analyzes colonoscopy footage
Milestones
Potential Needs/Wish List
We plan to design a method to automate polyp counting that would
both increase efficiency and decrease time spent counting polyps. In
order to develop the proper solution, we will need access to:
• Videos of colonoscopies to use for testing purposes
• Viewing current solution
• Gastroenterologists who perform colonoscopies
References
[1] Kendell Keck, M.D. Interview September 9th, 2016
[2] Gastrointest Endosc. 2013 Mar;77(3):455-63. doi: 10.1016/j.gie.2012.11.038. Epub 2013 Jan
18. Global quantitative assessment of the colorectal polyp burden in familial adenomatous
polyposis by using a web-based tool
[3] Background and Motivation (image) :
https://en.wikipedia.org/wiki/Familial_adenomatous_polyposis
[4] Van de Meeberg, M. M., Ouwendijk, R. J. T., ter Borg, P. C. J., van den Hazel, S. J., & van de
Meeberg, P. C. (2016). The Polyp Manager: a new tool for optimal polyp documentation during
colonoscopy. A pilot study. Endoscopy International Open, 4(5), E572–E576.
http://doi.org/10.1055/s-0042-103414
[5] Perencevich, M., & Stoffel, E. M. (2011). A Multidisciplinary Approach to the Diagnosis and
Management of Multiple Colorectal Polyps. Gastroenterology & Hepatology, 7(6), 420–423.
[6] Colucci, P. M., Yale, S. H., & Rall, C. J. (2003). Colorectal Polyps. Clinical Medicine and
Research, 1(3), 261–262.
Team 12
Functional
Requirement
Design Parameters
Analysis/
Testing
Procedure
References
Count polyps
during a
colonoscopy
Must provide an accurate
count of polyps in the
colon and rectum
Test using sample
videos with a
known polyp count
Dr. Keck
Provide count in a
timely manner
< 5 minutes to upload
video, setup and run
software
Measure amount
of time needed for
upload and
execution
Dr. Keck
Scope/Software
Compatibility
Compatible with Olympus
scopes and other
software
Test with sample
videos obtained
from scopes
Dr. Keck
Mobile Can be used throughout
hospital
Test on multiple
systems
N/A
Easy for physicians
to use/”User
friendly” interface
< 5 minutes to learn to
use
Run trials with
gastro-
enterologists at
UIHC
N/A
9/5 9/12 9/19 9/26 10/3 10/10 10/17 10/24 10/31 11/7 11/14 Break 11/28 12/5
Identify Problem and Research Prior Art
Develop Need Statement/
Functional Requirements
Research Strategy Options
Poster Session Advisory Council
Select Top Strategy
Develop Concepts/
Explore Software Options
Select and Model Best Concept
Develop Prototype
Test Prototype using Sample Videos
Finalize Prototype
Image Source: [3]
The Polyp manager (PM) is a
software application that documents
polyps in real time during a
colonoscopy. The endoscopist can
document all polyps during a
colonoscopy with its touchscreen
interface. Even though it is a user-
friendly tool that can improve
completeness of polyp reporting, it
does not necessarily time saving
time.Image Source: [4]
Researchers from the University
of Texas developed a secure
web-based tool that uses a
browser supporting Windows
Media Player to deliver the high-
definition videos. Colonoscopy
videos are captured in DVD
format. The results are
reproducible but software that
asses the findings is still
desirable. Picture of the scoring screen for the web-based
tool. B–D. Higher-magnification views of the
pieces of the scoring screen: the scoring card (B),
streaming video (C), and list of videos (D). Image
Source: [2]
Insights about Problem
An endoscopic examination is
often the initial opportunity for
assembling data. Recording
the rectal polyp burden is
important for making decisions
concerning surgical
management. Counting polyps
and calculating polyp
diameters in real time during
colonoscopic procedures can
be impractical because of the
large number of polyps.
Prior Art
Image Source: [6]