The Next Big Think: Artificial Intelligence Arrives at Penn Gastroenterology

GI Genius™ monitor in use. Image © Medtronic 2023
GI Genius™ monitor in use. Image © Medtronic 2023


In the fall of 2022, Penn Gastroenterology and Hepatology received a grant for the Department to incorporate GI Genius™, the first FDA-approved device to use artificial intelligence (AI) to assist clinicians in colon polyp detection in real time during a colonoscopy.

"This specific grant was to offer AI technology for underserved communities," says Penn Gastroenterologist Neilanjan Nandi, MD, FACP. "We applied for this grant in order to enhance colon polyp detection rates in our West Philadelphia community with the ultimate goal to further reduce colon cancer in our local population."


  • AI is the study of algorithms that give machines the ability to reason and perform cognitive functions, and encompasses the field of machine learning and its inter-related sub-domains.
  • Colorectal cancer (CRC) is the third leading cause of death from cancer in the United States. Preventative screening for CRC can significantly reduce disease risk and mortality. A collection of challenges, including lack of access to care and irregularities in insurance coverage, have historically presented barriers to screening in medically underserved populations.

Improving access to care in the underserved community is among the founding missions of Penn Medicine. With regard to CRC in particular, this means access to colonoscopy and other essential screening modalities, and participation in screening programs. Cohort studies in targeted populations suggest that colonoscopy can bring about substantial reduction in CRC mortality.

Periodic screening and surveillance colonoscopy can substantially reduce the risk of colorectal cancer development and reduce associated mortality by catching polyps early. However, despite regular lifetime adherence to a colon polyp surveillance schedule, there is still a 5-9 percent risk of developing an "interval" colon cancer. This inherent small risk is due to the potential miss small polyps during a colonoscopy that may evade detection and transform over time into a cancer. High quality preparation and high quality endoscopic skill are necessary to maximize the adenoma detection rate (ADR). The national ADR benchmark is 26 percent across the country. Penn medicine gastroenterologists currently far surpass this benchmark significantly at ~38 percent ADR. While early detection of stage 1 – 3 colon cancer is associated with at least 85 percent five-year remission rates, optimizing ADR to find and resect adenomas is the key to complete colon cancer prevention. Therefore, tools that can aid in the increased visualization of colon adenomas can help the endoscopist remove these polyps to ultimately prevent future colon cancer pathogenesis.

The aim of GI Genius™ is to apply AI technology during colonoscopy in order to detect more colon polyps and reduce adenoma miss rates so that people don't develop interval colon cancers" says Dr. Nandi.

GI Genius: Endoscopy Powered by AI

GI Genius ™ is composed of an artificial intelligence algorithm that aids endoscopists in highlighting portions of the colon where a potential polyp may be lurking. During colonoscopy, the system superimposes real time markers on the endoscopic camera video feed that suggest the presence of a potential lesion being identified. These signal to the clinician that further assessment and intervention may be needed. In real-time, the endoscopist may need to provide closer visual inspection, tissue sampling, and/or polyp resection or ablation. Ultimately, it's to the clinician's clinical discretion how to manage a colon polyp per their best clinical judgement and per standardized clinical practice guidelines.


The safety and effectiveness of GI Genius™ was studied through a multicenter, prospective, randomized, controlled study with 700 individuals ranging in age from 40-80 years old. These individuals were undergoing colonoscopy for colorectal cancer screening, colon polyp surveillance, positive fecal immunochemical test for blood in the stool, or reported gastrointestinal symptoms of possible colorectal cancer. Study subjects underwent either standard white light colonoscopy alone or standard white light colonoscopy with the GI Genius. Study results illustrated that colonoscopy utilizing GI Genius was able to identify pathology-confirmed adenomas or carcinomas in 55.1 percent of patients compared to 42.0 percent of patients with standard colonoscopy, an observed difference of 13 percent.

"We are still in the early days of adopting AI in colon cancer prevention as routine, but the data suggests that it can improve ADR and it may become a standard of care in the years to come," says Dr. Nandi. Remaining challenges include the additional financial costs of new technology and insurance reimbursement. In the interim, Penn Presybterian Gastroenterology is proud to pilot this technology at no cost to our community.

AI at Penn Medicine

The study of artificial Intelligence is being advanced throughout Penn Medicine at both the Perelman School of Medicine and the Abramson Cancer Center.

Recent developments include: