{
  "abstract": "During peroral cholangioscopy-guided electrohydraulic lithotripsy (EHL), stone fragmentation obscures the visual field (the \"snowstorm effect\"), and visualization quality has been assessed only subjectively. This proof-of-concept study explored the feasibility of a deep-learning method for objectively quantifying visualization quality during EHL and, as an exploratory application, compared viscous gel immersion with saline irrigation. A ResNet-18 model was trained on expert-annotated frames (5-point scale) from three development cases. For independent validation, 120 frames from 12 previously unseen comparison cases were scored by two blinded endoscopists (inter-reader weighted κ = 0.98). The model showed only moderate agreement with their consensus (weighted κ = 0.60; accuracy 70.8%); because the validation sample was enriched for predicted-usable frames, metrics re-weighted to the natural frame distribution gave sensitivity 29.8% and specificity 93.5%, indicating systematic under-detection of usable views. Agreement did not differ systematically between gel and saline frames. The High-Quality View Rate (HQVR) was the proportion of EHL-phase frames scored Good/Excellent. In a patient-level comparison, median HQVR was 22.7% for gel versus 8.4% for saline (exact Mann-Whitney U, p = 0.15, not significant); in post hoc exploratory analyses, a threshold-independent mean predicted score differed (1.65 vs. 1.35, p = 0.005) and the longest continuous usable interval favored gel (median 24.4 vs. 5.2 s). Mild cholangitis occurred in 1/5 gel and 4/7 saline patients. Training such a model is feasible, but it is not yet a validated measurement tool, and the gel-versus-saline signal is hypothesis-generating only. Larger multi-case training and prospective validation are required. Trial Registration: N/A.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kagawa Japan.",
    "Department of Gastroenterological Surgery, Faculty of Medicine Kagawa University Takamatsu Japan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hideki Kamada"
    },
    {
      "affs": [
        0
      ],
      "name": "Kiyoyuki Kobayashi"
    },
    {
      "affs": [
        0
      ],
      "name": "Hiroki Yamana"
    },
    {
      "affs": [
        0
      ],
      "name": "Naoki Fujita"
    },
    {
      "affs": [
        0
      ],
      "name": "Daisuke Namima"
    },
    {
      "affs": [
        0
      ],
      "name": "Manabu Yamada"
    },
    {
      "affs": [
        0
      ],
      "name": "Syunsuke Fujita"
    },
    {
      "affs": [
        1
      ],
      "name": "Hironobu Suto"
    },
    {
      "affs": [
        1
      ],
      "name": "Keiichi Okano"
    },
    {
      "affs": [
        0
      ],
      "name": "Hideki Kobara"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a7qx7k15vvyw6.bib",
  "cited_by": 0,
  "doi": "10.1002/deo2.70454",
  "fulltext_url": "https://europepmc.org/articles/PMC13678035",
  "id": "a7qx7k15vvyw6",
  "issns": [
    "2692-4609"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898633",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Gallbladder and Bile Duct Disorders"
    ]
  ],
  "openalex": "W7222928781",
  "pdf_url": "https://europepmc.org/articles/PMC13678035?pdf=render",
  "pmcid": "PMC13678035",
  "pmid": "42898633",
  "published": "2026-10-18",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a7qx7k15vvyw6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42898633",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898633"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Gallbladder and Bile Duct Disorders",
      "subfield": "general"
    }
  ],
  "title": "Feasibility of a Deep-Learning Model for Objective Visualization-Quality Assessment During Cholangioscopy-Guided Lithotripsy: A Proof-of-Concept Study.",
  "title_text": "Feasibility of a Deep-Learning Model for Objective Visualization-Quality Assessment During Cholangioscopy-Guided Lithotripsy: A Proof-of-Concept Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/a7qx7k15vvyw6",
  "venue": "DEN open",
  "versions": []
}