Spatio-Temporal Characterization of Gastric Distensibility in Upper Endoscopy Identifies the Presence of <i>Helicobacter pylori</i>

Abstract

Assessment of gastric distensibility is crucial for understanding various gastrointestinal disorders, particularly those affecting gastric motility and reflux conditions. Gastric distensibility can be altered by pathological conditions such as linitis plastica or gastric mucosal inflammation, as seen in Helicobacter pylori infections. Although distensibility is evaluated during routine endoscopy, the assessment remains purely visual. Moreover, some specialized endoscopic tools assess only specific gastric regions and are often unavailable. Artificial intelligence tools may used to estimate the gastric three-dimensional surface from the endoscopy video and capture temporal distensibility changes of the gastric surface. This paper introduces a novel spatio-temporal characterization of the gastric distensibility during a routine endoscopy procedure. The method reconstructs the gastric surface for each frame of a short endoscopy video using a shape-from-shading network trained with a synthetic endoscopy collection. Local and regional changes in surface bending are then quantified, which herein depend on the distensibility. This spatio-temporal characterization was applied to a group of 160 patients, among them 60 diagnosed with Helicobacter pylori confirmed by pathology examination. The obtained characteristics in three different regions: body, antrum, and pylorus, demonstrated significant differences between patients with and without Helicobacter pylori under a t-test ( p<0.05 ). The proposed method effectively captures subtle gastric wall bending from routine endoscopy videos, providing a strategy for analyzing distensibility in pathological conditions across various gastric regions without requiring specialized tools.