Quanlin Li

Ruijie Yang, Yan Zhu, Peiyao Fu et al.

Automatic speech recognition (ASR) is a critical interface for human-AI interaction in gastrointestinal endoscopy, yet its reliability in real-world clinical settings is limited by domain-specific terminology and complex acoustic conditions. Here, we present EndoASR, a domain-adapted ASR system designed for real-time deployment in endoscopic workflows. We develop a two-stage adaptation strategy based on synthetic endoscopy reports, targeting domain-specific language modeling and noise robustness. In retrospective evaluation across six endoscopists, EndoASR substantially improves both transcription accuracy and clinical usability, reducing character error rate (CER) from 20.52% to 14.14% and increasing medical term accuracy (Med ACC) from 54.30% to 87.59%. In a prospective multi-center study spanning five independent endoscopy centers, EndoASR demonstrates consistent generalization under heterogeneous real-world conditions. Compared with the baseline Paraformer model, CER is reduced from 16.20% to 14.97%, while Med ACC is improved from 61.63% to 84.16%, confirming its robustness in practical deployment scenarios. Notably, EndoASR achieves a real-time factor (RTF) of 0.005, significantly faster than Whisper-large-v3 (RTF 0.055), while maintaining a compact model size of 220M parameters, enabling efficient edge deployment. Furthermore, integration with large language models demonstrates that improved ASR quality directly enhances downstream structured information extraction and clinician-AI interaction. These results demonstrate that domain-adapted ASR can serve as a reliable interface for human-AI teaming in gastrointestinal endoscopy, with consistent performance validated across multi-center real-world clinical settings.

Jia Yu, Yan Zhu, Peiyao Fu et al.

Rare gastrointestinal lesions are infrequently encountered in routine endoscopy, restricting the data available for developing reliable artificial intelligence (AI) models and training novice clinicians. Here we present EndoRare, a one-shot, retraining-free generative framework that synthesizes diverse, high-fidelity lesion exemplars from a single reference image. By leveraging language-guided concept disentanglement, EndoRare separates pathognomonic lesion features from non-diagnostic attributes, encoding the former into a learnable prototype embedding while varying the latter to ensure diversity. We validated the framework across four rare pathologies (calcifying fibrous tumor, juvenile polyposis syndrome, familial adenomatous polyposis, and Peutz-Jeghers syndrome). Synthetic images were judged clinically plausible by experts and, when used for data augmentation, significantly enhanced downstream AI classifiers, improving the true positive rate at low false-positive rates. Crucially, a blinded reader study demonstrated that novice endoscopists exposed to EndoRare-generated cases achieved a 0.400 increase in recall and a 0.267 increase in precision. These results establish a practical, data-efficient pathway to bridge the rare-disease gap in both computer-aided diagnostics and clinical education.