@article {ali2021polypgen,
	title = {A multi-center polyp detection and segmentation dataset for generalisability assessment},
	journal = {Nature Scientific Data},
	volume = {10},
	year = {2023},
	publisher = {Nature},
	doi = {https://doi.org/10.1038/s41597-023-01981-y},
	url = {https://doi.org/10.1038/s41597-023-01981-y},
	author = {Ali, Sharib and Jha, Debesh and Ghatwary, Noha and Realdon, Stefano and Cannizzaro, Renato and Osama E {Salem} and Lamarque, Dominique and Daul, Christian and Kim V {Anonsen} and Riegler, Michael and Kim V. {{\r A}nonsen} and Petlund, Andreas and Halvorsen, P{\r a}l and Rittscher, Jens and de Lange, Thomas and James E. {East}}
}
@inproceedings {42722,
	title = {PolypConnect: Image inpainting for generating realistic gastrointestinal tract images with polyps},
	journal = {IEEE 35th International Symposium on Computer-Based Medical Systems (CBMS)},
	year = {2022},
	month = {07/2022},
	pages = {66-71},
	publisher = {IEEE},
	abstract = {Early identification of a polyp in the lower gastrointestinal (GI) tract can lead to prevention of life-threatening colorectal cancer. Developing computer-aided diagnosis (CAD) systems to detect polyps can improve detection accuracy and efficiency and save the time of the domain experts called endoscopists. Lack of annotated data is a common challenge when building CAD systems. Generating synthetic medical data is an active research area to overcome the problem of having relatively few true positive cases in the medical domain. To be able to efficiently train machine learning (ML) models, which are the core of CAD systems, a considerable amount of data should be used. In this respect, we propose the PolypConnect pipeline, which can convert non-polyp images into polyp images to increase the size of training datasets for training. We present the whole pipeline with quantitative and qualitative evaluations involving endoscopists. The polyp segmentation model trained using synthetic data, and real data shows a 5.1\% improvement of mean intersection over union (mIOU), compared to the model trained only using real data. The codes of all the experiments are available on GitHub to reproduce the results.},
	doi = {10.1109/CBMS55023.2022.00019},
	author = {Jan Andre {Fageren} and Thambawita, Vajira and Stor{\r a}s, Andrea and Parasa, Sravanthi and de Lange, Thomas and Halvorsen, P{\r a}l and Riegler, Michael}
}
@misc {42764,
	title = {Visual explanations for polyp detection: How medical doctors assess intrinsic versus extrinsic explanations},
	year = {2022},
	publisher = {arXiv},
	doi = {10.48550/arXiv.2204.00617},
	url = {https://arxiv.org/abs/2204.00617},
	author = {Hicks, Steven and Stor{\r a}s, Andrea and Riegler, Michael and Midoglu, Cise and Hammou, Malek and de Lange, Thomas and Parasa, Sravanthi and Halvorsen, P{\r a}l and Str{\"u}mke, Inga}
}
@article {27774,
	title = {A comprehensive analysis of classification methods in gastrointestinal endoscopy imaging},
	journal = {Medical Image Analysis},
	volume = {70},
	year = {2021},
	pages = {102007},
	publisher = {Elsevier},
	abstract = {Gastrointestinal endoscopy has\&nbsp;been\&nbsp;an\&nbsp;active field\&nbsp;of research motivated by the large number of highly lethal GI cancers. Early GI cancer precursors are often missed during the endoscopic surveillance. \&nbsp; The high missed rate of such abnormalities during endoscopy is thus a\&nbsp; critical bottleneck. Lack of attentiveness due to tiring procedures, and requirement of training are few contributing factors. An automatic\&nbsp; GI\&nbsp; disease classification system can help reduce such risks by flagging suspicious frames and lesions. GI endoscopy consists of several multi-organ surveillance, therefore, there is need to develop methods that can generalize to various endoscopic findings. In this realm, we present a comprehensive analysis of the\&nbsp; Medico\&nbsp; GI\&nbsp; challenges:\&nbsp; Medical\&nbsp; Multimedia Task at MediaEval 2017, Medico Multimedia Task at MediaEval 2018,\&nbsp; and\&nbsp; BioMedia\&nbsp; ACM\&nbsp; MM\&nbsp; Grand\&nbsp; Challenge\&nbsp; 2019.\&nbsp; These challenges are initiative to set-up\&nbsp; a\&nbsp; benchmark for different computer vision methods applied to the multi-class endoscopic images and promote to build new approaches that could reliably be used in clinics. We report the performance of 21 participating teams over a\&nbsp; period of three consecutive years and provide a\&nbsp; detailed analysis of the methods used by the participants, highlighting the challenges and shortcomings of the current approaches and dissect their credibility for the use in clinical settings.\&nbsp; Our analysis revealed that the participants achieved an improvement on maximum\&nbsp; Mathew correlation coefficient\&nbsp; (MCC)\&nbsp; from\&nbsp; 82.68\%\&nbsp; in\&nbsp; 2017\&nbsp; to\&nbsp; 93.98\%\&nbsp; in\&nbsp; 2018\&nbsp; and 95.20\% in 2019 challenges, and a significant increase in computational speed over consecutive years.},
	keywords = {Artificial intelligence, BioMedia 2019 Grand Challenge, Computer-aided detection and diagnosis, Gastrointestinal endoscopy challenges, Medical imaging, Medico Task 2017, Medico Task 2018},
	doi = {https://doi.org/10.1016/j.media.2021.102007},
	author = {Jha, Debesh and Ali, Sharib and Hicks, Steven and Thambawita, Vajira and Borgli, Hanna and Pia H. {Smedsrud} and de Lange, Thomas and Pogorelov, Konstantin and Wang, Xiaowei and Harzig, Philipp and Tran, Minh-Triet and Meng, Wenhua and Hoang, Trung-Hieu and Dias, Danielle and Tobey H. {Ko} and Agrawal, Taruna and Ostroukhova, Olga and Khan, Zeshan and Muhammad Atif {Tahir} and Liu, Yang and Chang, Yuan and Kirker{\o}d, Mathias and Johansen, Dag and Lux, Mathias and H{\r a}vard D. {Johansen} and Riegler, Michael and Halvorsen, P{\r a}l}
}
@article {27640,
	title = {A Comprehensive Study on Colorectal Polyp Segmentation with ResUNet++, Conditional Random Field and Test-Time Augmentation},
	journal = {IEEE Journal of Biomedical and Health Informatics},
	volume = {25},
	year = {2021},
	pages = {2029 - 2040},
	publisher = { IEEE},
	abstract = {Colonoscopy is considered the gold standard for detection of colorectal cancer and its precursors. Existing examination methods are, however, hampered by high overall miss-rate, and many abnormalities are left undetected. Computer-Aided Diagnosis systems based on advanced machine learning algorithms are touted as a game-changer that can identify regions in the colon overlooked by the physicians during endoscopic examinations, and help detect and characterize lesions. In previous work, we have proposed the ResUNet++ architecture and demonstrated that it produces more efficient results compared with its counterparts U-Net and ResUNet. In this paper, we demonstrate that further improvements to the overall prediction performance of the ResUNet++ architecture can be achieved by using Conditional Random Field (CRF) and Test-Time Augmentation (TTA). We have performed extensive evaluations and validated the improvements using six publicly available datasets: Kvasir-SEG, CVC-ClinicDB, CVC-ColonDB, ETIS-Larib PolypDB, ASU-Mayo Clinic Colonoscopy Video Database, and CVC-VideoClinicDB. Moreover, we compare our proposed architecture and resulting model with other State-of-the-art methods. To explore the generalization capability of ResUNet++ on different publicly available polyp datasets, so that it could be used in a real-world setting, we performed an extensive cross-dataset evaluation. The experimental results show that applying CRF andTTA improves the performance on various polyp segmentation datasets both on the same dataset and cross-dataset. To check the model{\textquoteright}s performance on difficult to detect polyps, we selected, with the help of an expert gastroenterologist,196sessile or flat polyps that are less than ten millimeters in size. This additional data has been made available as a subset of Kvasir-SEG. Our approaches showed good results for flat or sessile and smaller polyps, which are known to be one of the major reasons for high polyp miss-rates. This is one of the significant strengths of our work and indicates that our methods should be investigated further for use in clinical practice.},
	keywords = {colonoscopy, conditional random field, generalization, Polyp segmentation, ResUNet++, test-time augmentation},
	doi = {10.1109/JBHI.2021.3049304},
	author = {Jha, Debesh and Pia H. {Smedsrud} and Johansen, Dag and de Lange, Thomas and H{\r a}vard D. {Johansen} and Halvorsen, P{\r a}l and Riegler, Michael}
}
@inproceedings {27834,
	title = {DeepSynthBody: the beginning of the end for data deficiency in medicine},
	journal = {The International Conference on Applied Artificial Intelligence (ICAPAI)},
	year = {2021},
	publisher = {IEEE},
	abstract = {Limited access to medical data is a barrier on developing new and efficient machine learning solutions in medicine such as computer-aided diagnosis, risk assessments, predicting optimal treatments and home-based personal healthcare systems. This paper presents DeepSynthBody: a novel framework that overcomes some of the inherent restrictions and limitations of medical data by using deep generative adversarial networks to produce synthetic data with characteristics similar to the real data, so-called DeepSynth (deep synthetic) data. We show that DeepSynthBody can address two key issues commonly associated with medical data, namely privacy concerns (as a result of data protection rules and regulations) and the high costs of annotations. To demonstrate the full pipeline of applying DeepSynthBody concepts and user-friendly functionalities, we also describe a synthetic medical dataset generated and published using our framework. DeepSynthBody opens a new era of machine learning applications in medicine with a synthetic model of the human body.},
	doi = {10.1109/ICAPAI49758.2021.9462062},
	author = {Thambawita, Vajira and Hicks, Steven and Isaksen, Jonas and Mette Haug {Stensen} and Trine B {Haugen} and Kanters, J{\o}rgen and Parasa, Sravanthi and de Lange, Thomas and H{\r a}vard D. {Johansen} and Johansen, Dag and Hugo Lewi {Hammer} and Halvorsen, P{\r a}l and Riegler, Michael}
}
@inproceedings {27511,
	title = {Kvasir-Instrument: Diagnostic and therapeutic tool segmentation dataset in gastrointestinal endoscopy},
	journal = {27th International Conference on Multimedia Modeling},
	volume = {LNCS, volume 12573},
	year = {2021},
	pages = {218-229},
	publisher = {Springer},
	abstract = {Gastrointestinal (GI) pathologies are periodically screened, biopsied, and resected using surgical tools. Usually the procedures and the treated or resected areas are not specifically tracked or analysed during or after colonoscopies. Information regarding disease borders, development and amount and size of the resected area get lost. This can lead to poor follow-up and bothersome reassessment difficulties post-treatment. To improve the current standard and also to foster more research on the topic we have released the\&nbsp; {\textquoteleft}{\textquoteleft}Kvasir Instrument{\textquoteright}{\textquoteright} dataset which consists of $590$ annotated frames containing GI procedure tools such as snares, balloons and biopsy forceps, etc. Beside of the images, the dataset includes ground truth masks and bounding boxes and has been verified by two expert GI endoscopists. Additionally, we provide a baseline for the segmentation of the GI tools to promote research and algorithm development. We obtained a dice coefficient score of 0.9158 and a Jaccard index of 0.8578 using a classical U-Net architecture. A similar dice coefficient score was observed for DoubleUNet. The qualitative results showed that the model did not work for the images with specularity and the frames with multiple instruments, while the best result for both methods was observed on all other types of images. Both, qualitative and quantitative results show that the model performs reasonably good, but there is a large potential for further improvements.\&nbsp; Benchmarking using the dataset provides an opportunity for researchers to contribute to the field of automatic endoscopic diagnostic and therapeutic tool segmentation for GI endoscopy.\&nbsp;},
	author = {Jha, Debesh and Ali, Sharib and Emanuelsen, Krister and Hicks, Steven and Thambawita, Vajira and Garcia-Ceja, Enrique and Riegler, Michael and de Lange, Thomas and Peter T. {Schmidt} and H{\r a}vard D. {Johansen} and Johansen, Dag and Halvorsen, P{\r a}l}
}
@inproceedings {40625,
	title = {Medico Multimedia Task at MediaEval 2021: Transparency in Medical Image Segmentation},
	journal = {Mediaeval Medico 2021},
	year = {2021},
	publisher = {Mediaeval 2021},
	abstract = {The Medico Multimedia Task\&nbsp;focuses on providing multimedia researchers with the opportunity to contribute to different areas of medicine using multimedia data to solve several subtasks. This year, the task focuses on transparency within machine learning-based medical segmentation systems, where the use case is gastrointestinal endoscopy. In this paper, we motivate the organization of this task, describe the development and test dataset, and present the evaluation process used to assess the participants{\textquoteright} submissions.},
	url = {https://2021.multimediaeval.com/},
	author = {Hicks, Steven and Jha, Debesh and Thambawita, Vajira and Hugo Lewi {Hammer} and de Lange, Thomas and Parasa, Sravanthi and Riegler, Michael and Halvorsen, P{\r a}l}
}
@inproceedings {27856,
	title = {NanoNet: Real-Time Polyp Segmentation in Video Capsule Endoscopy and Colonoscopy},
	journal = {34th IEEE CBMS International Symposium on Computer-Based Medical Systems},
	year = {2021},
	publisher = { IEEE},
	abstract = {Deep learning in gastrointestinal endoscopy can assist to improve clinical performance and be helpful to assess lesions more accurately. To this extent, semantic segmentation methods that can perform automated real-time delineation of a region-of-interest, e.g., boundary identification of cancer or precancerous lesions, can benefit both diagnosis and interventions. However, accurate and real-time segmentation of endoscopic images is extremely challenging due to its high operator dependence and high-definition image quality. To utilize automated methods in clinical settings, it is crucial to design lightweight models with low latency such that they can be integrated with low-end endoscope hardware devices. In this work, we propose NanoNet, a novel architecture for the segmentation of video capsule endoscopy and colonoscopy images. Our proposed architecture allows real-time performance and has higher segmentation accuracy compared to other more complex ones. We use video capsule endoscopy and standard colonoscopy datasets with polyps, and a dataset consisting of endoscopy biopsies and surgical instruments, to evaluate the effectiveness of our approach. Our experiments demonstrate the increased performance of our architecture in terms of a trade-off between model complexity, speed, model parameters, and metric performances. Moreover, the resulting model size is relatively tiny, with only nearly 36,000 parameters compared to traditional deep learning approaches having millions of parameters.},
	keywords = {colonoscopy, deep learning, segmentation, tool  segmentation, Video capsule endoscopy},
	author = {Jha, Debesh and Nikhil Kumar {Tomar} and Ali, Sharib and Riegler, Michael and H{\r a}vard D {Johansen} and Johansen, Dag and de Lange, Thomas and Halvorsen, P{\r a}l}
}
@inproceedings {39534,
	title = {Kvasir-instrument: Diagnostic and therapeutic tool segmentation dataset in gastrointestinal endoscopy},
	journal = {International Conference on Multimedia Modeling},
	year = {2020},
	publisher = { Springer},
	abstract = {Gastrointestinal\&nbsp;pathologies are periodically screened, biopsied, and resected using surgical tools. Usually, the procedures and the treated or resected areas are not specifically tracked or analysed during or after colonoscopies. Information regarding disease borders, development,\&nbsp; amount, and size of the resected area get lost. This can lead to poor follow-up and bothersome reassessment difficulties post-treatment. To improve the current standard and also to foster more research on the topic, we have released the\&nbsp; {\textquoteleft}{\textquoteleft}Kvasir-Instrument{\textquoteright}{\textquoteright} dataset, which consists of 590\&nbsp;annotated frames containing GI\&nbsp;procedure tools such as snares, balloons, and biopsy forceps, etc. Besides the images, the dataset includes ground truth masks and bounding boxes and has been verified by two expert GI\&nbsp;endoscopists. Additionally, we provide a baseline for the segmentation of the GI tools to promote research and algorithm development. We obtained a dice coefficient score of 0.9158\&nbsp;and a Jaccard index of 0.8578\&nbsp;using a classical U-Net architecture. A similar dice coefficient score was observed for DoubleUNet. The qualitative results showed that the model did not work for the images with specularity and the frames with multiple tools, while the best result for both methods was observed on all other types of images. Both qualitative and quantitative results show that the model performs reasonably good, but there is potential for further improvements.\&nbsp; Benchmarking using the dataset provides an opportunity for researchers to contribute to the field of automatic endoscopic diagnostic and therapeutic tool segmentation for GI\&nbsp;endoscopy.},
	keywords = {Benchmarking, Convolutional  neural network, Gastrointestinal endoscopy, Tool segmentation},
	url = {https://www.springerprofessional.de/en/kvasir-instrument-diagnostic-and-therapeutic-tool-segmentation-d/18788368},
	author = {Jha, Debesh and Ali, Sharib and Emanuelsen, Krister and Hicks, Steven and Thambawita, Vajira and Garcia-Ceja, Enrique and Riegler, Michael and de Lange, Thomas and Peter T. {Schmidt} and H{\r a}vard D {Johansen} and Johansen, Dag and Halvorsen, P{\r a}l}
}
@inproceedings {26811,
	title = {Kvasir-SEG: A Segmented Polyp Dataset},
	journal = {International Conference on Multimedia Modeling},
	year = {2020},
	pages = {451-462},
	publisher = {Springer},
	address = {Daejeon, Korea},
	abstract = {Pixel-wise image segmentation is a highly demanding task in medical image analysis. In practice, it is difficult to find annotated medical images with corresponding segmentation masks. In this paper, we present\&nbsp; Kvasir-SEG: an open-access dataset of gastrointestinal polyp images and corresponding segmentation masks, manually annotated and verified by an experienced gastroenterologist. We demonstrate the use of our dataset with a traditional segmentation approach and a modern deep learning based CNN approach. This work will be valuable for researchers to reproduce results and compare their methods in the future.\&nbsp;By adding segmentation masks to the Kvasir dataset, which until today only consisted of framewise annotations, we enable multimedia and computer vision researchers to contribute in the field of polyp segmentation and automatic analysis of colonoscopy videos.\&nbsp;\&nbsp;},
	keywords = {Kvasir-SEG dataset, Medical images, Polyp segmentation, ResUNet  Fuzzy c-mean clustering, Semantic segmentation},
	author = {Jha, Debesh and Pia H. {Smedsrud} and Riegler, Michael and Halvorsen, P{\r a}l and H{\r a}vard D. {Johansen} and de Lange, Thomas and Johansen, Dag}
}
@inproceedings {27637,
	title = {Medico Multimedia Task at MediaEval 2020: Automatic Polyp Segmentation},
	journal = {Medico MediaEval 2020},
	year = {2020},
	publisher = {CEUR},
	abstract = {Colorectal cancer is the third most common cause of cancer worldwide. According to Global cancer statistics 2018, the incidence of colorectal cancer is increasing in both developing and developed countries. Early detection of colon anomalies such as polyps is important for cancer prevention, and automatic polyp segmentation can play a crucial role for this. Regardless of the recent advancement in early detection and treatment options, the estimated polyp miss rate is still around 20\%. Support via an automated computer-aided diagnosis system could be one of the potential solutions for the overlooked polyps. Such detection systems can help low-cost design solutions and save doctors time, which they could for example use to perform more patient examinations. In this paper, we introduce the 2020 Medico challenge, provide some information on related work and the dataset, describe the task and evaluation metrics, and discuss the necessity of organizing the Medico challenge.},
	author = {Jha, Debesh and Hicks, Steven and Emanuelsen, Krister and H{\r a}vard D. {Johansen} and Johansen, Dag and de Lange, Thomas and Riegler, Michael and Halvorsen, P{\r a}l}
}
@article {26546,
	title = {Deep Learning for Automatic Generation of Endoscopy Reports},
	journal = {Gastrointestinal Endoscopy},
	volume = {89},
	year = {2019},
	month = {06/2019},
	publisher = {Elsevier},
	address = {Gastrointestinal Endoscopy},
	doi = {10.1016/j.gie.2019.04.053},
	author = {Hicks, Steven and Pia H. {Smedsrud} and Riegler, Michael and de Lange, Thomas and Petlund, Andreas and Sigrun Losada {Eskeland} and Pogorelov, Konstantin and Peter Thelin {Schmidt} and Halvorsen, P{\r a}l}
}
@misc {runeGTC2019,
	title = {Efficient Processing of Medical Videos in a Multi-auditory Environment Using Gpu Lending},
	year = {2019},
	address = {NVIDIA{\textquoteright}s GPU Technology Conference (GTC)},
	author = {Borgli, Rune and Pogorelov, Konstantin and Riegler, Michael and Markussen, Jonas and H{\r a}kon Kvale {Stensland} and Halvorsen, P{\r a}l and Griwodz, Carsten and Sigrun Losadal {Eskeland} and de Lange, Thomas}
}
@misc {26509,
	title = {Kunstig intelligens for endoskopi {\textendash} Automatisk deteksjon av lesjoner i sanntid},
	year = {2019},
	publisher = {Norsk Gastroenterologisk Forening},
	address = {NGF Nytt, Vol. 26, No 1, March 2019, p. 34},
	abstract = {BAKGRUNN: I krysningspunktet mellom matematikk, informatikk og statistikk finner vi den vitenskapelige disiplinen kunstig intelligens (KI). Sammen med de siste {\r a}rs eksplosive utvikling innen teknologi har KI muliggjort nye algoritmer, modeller og systemer for maskinassistert diagnostikk. Resultater fra KI basert p{\r a} dype nevrale nettverk har vist spesielt stort potensiale, ogs{\r a} for automatisk deteksjon av lesjoner og anatomiske landemerker i gastrointestinaltraktus under endoskopi. Med sensitivitet og spesifisitet for deteksjon av polypper i tykktarmp{\r a} over 90\% m{\o}ter slike metoder n{\o}dvendige kliniske krav, men mange eksperimenter er utf{\o}rt p{\r a} begrensede datasett, eller analysert p{\r a} feilaktig grunnlag grunnet manglende tilgang og forst{\r a}else hos informatikere. For {\r a} oppn{\r a} best mulig resultat eret interdisiplin{\ae}rt samarbeid mellom klinikere og informatikereen forutsetning. Informatikerne trenger medisinske innspill for {\r a} lage effektive systemer som fungerer ute i klinikken, og klinikerne trenger forst{\r a}else av systemet for {\r a} kunne stole p{\r a} resultatet og stille p{\r a}litelige diagnoser. En stor utfordring for denne tilliten erat fremgangsm{\r a}ten til en KI-algoritme sees p{\r a} som en svart boks hvor ingen n{\o}yaktig kan dechiffrere hvordan systemet kom fremtil sin konklusjon.METODE: Vi har gjennom mange {\r a}r samlet en stor bilde- database fra endoskopier utf{\o}rt ved B{\ae}rum Sykehus, Vestre Viken HF. Bildene er gjennomg{\r a}tt og annotert av tre erfarne endoskop{\o}rer og fordelt p{\r a} 16 klasser, inkludert normal Z-linje, {\o}sofagitt, normal c{\o}kum, polypper og ulcer{\o}s colitt. Deretter er bildene brukt til {\r a} utvikle, trene og teste KI-modeller. Modellene er basert p{\r a} maskinl{\ae}ring og dyp l{\ae}ring, en gren innen KI. Med v{\r a}rt system Mimir, som kombinerer KI med informasjonss{\o}k og-gjenfinning, s{\o}ker vi {\r a} lage et helhetlig beslutningsst{\o}ttesystem for endoskop{\o}rer. Algoritmene analyserer videoer i sanntid, finner lesjoner, klassifiserer disse og gir skop{\o}ren live feedback om funn under unders{\o}kelsen, slik at funnene kan unders{\o}kes n{\ae}rmere. Mimir presenterer deretter resultatene i egen programvare, og bruker blant annet {\textquotedblleft}heatmaps{\textquotedblright} til {\r a} forklare hvordan konklusjonen er n{\r a}dd, og er p{\r a} den m{\r a}ten et bidrag p{\r a} veien til {\r a} forst{\r a} hvordan KI-algoritmene fungerer. Videre jobber vi med {\r a} videreutvikle Mimirs st{\o}tte for automatisk rapportgenerering, med bilderog standardtekst basert p{\r a} funn fra unders{\o}kelsen.RESULTATER: Deteksjon og klassifisering for de 16 gruppene har vist en sensitivitet p{\r a} 0,939 og en spesifisitet p{\r a} 0,996. Algoritmene v{\r a}re klarer {\r a} prosessere bildene i hastigheter p{\r a} mellom 30 - 1000 bilder per sekund, raskt nok til {\r a} kj{\o}re deteksjon i sanntid. En prototype av systemet er i samr{\r a}d med klinikere testet ved {\r a} koble til et koloskopisystem ute i klinikken, og kann{\r a} analysere videoer i sanntid.KONKLUSJON: Tester av v{\r a}re system viser at KI kan bli et viktig hjelpemiddel for {\r a} bedre oppdage GI-forandringer, og generere automatiske rapporter i l{\o}pet av n{\ae}rmeste fremtid. Dette kan fungere som viktig beslutningsst{\o}tte for endoskop{\o}rer, og kan brukes i oppl{\ae}ring av nye endoskop{\o}rer. Den st{\o}rste begrensningen med KI er at vi per i dag ikke vet hvordan systemet kommer frem til sin konklusjon, som kan p{\r a}virke i hvor stor grad vi stoler p{\r a} resultatet. Vi arbeider derfor med et helhetlig system som ikke bare hjelper legen med diagnostikk, men ogs{\r a} forklarer hvordan konklusjonen er n{\r a}dd, samt {\r a} generere automatiske rapporter fra unders{\o}kelsen.},
	author = {Pia H. {Smedsrud} and Riegler, Michael and de Lange, Thomas and Petlund, Andreas and Sigrun Losada {Eskeland} and Halvorsen, P{\r a}l}
}
@article {26857,
	title = {Maskinl{\ae}ringssystemer for gastrointestinale endoskopier},
	journal = {Best Practice Nordic - Gastroenterologi},
	year = {2019},
	month = {07/2019},
	publisher = {BestPracticeNordic},
	abstract = {Assistert diagnostikk med hjelp av kunstig intelligens (KI) har v{\ae}rt etterspurt lenge og kan bli et viktig hjelpemiddel innen medisin, godt hjulpet av den raske utviklingen innen maskinvare. Denne har gjort innf{\o}ringen av slike hjelpemidler mulig p{\r a} relativt kort sikt. Sikrere p{\r a}visning og klassifisering av funn og lesjoner innen radiologi og endoskopi er i ferd med {\r a} bli et viktig forskningsomr{\r a}de innen KI, og det fokuseres spesielt p{\r a} maskinl{\ae}ring. Imidlertid krever vellykket utvikling et komplett system som kan brukes i sanntid i daglig praksis, og som begrenser seg til utvikling av algoritmer. Det kreves ogs{\r a} store randomiserte studier for {\r a} fastsl{\r a} om kvaliteten og p{\r a}liteligheten til systemene er god. Vi deler i denne artikkelen v{\r a}re erfaringer fra utviklingen av et system for gastrointestinale endoskopier\&nbsp;og belyser viktige utfordringer for {\r a} skape en effektiv digital assistent.},
	url = {https://bestprac.no/maskinlaeringssystemer-for-gastrointestinale-endoskopier/},
	author = {Riegler, Michael and Pia H. {Smedsrud} and de Lange, Thomas and Halvorsen, P{\r a}l}
}
@inproceedings {26812,
	title = {ResUNet++: An Advanced Architecture for Medical Image Segmentation},
	journal = {2019 IEEE International Symposium on Multimedia (ISM)},
	year = {2019},
	publisher = {IEEE},
	address = {San Diego, California, USA},
	abstract = {Accurate computer-aided polyp detection and segmentation during colonoscopy examinations can help endoscopists resect abnormal tissue and thereby decrease chances of polyps growing into cancer. Towards developing a fully automated model for pixel-wise polyp segmentation, we propose ResUNet++, which is an improved ResUNet architecture for colonoscopic image segmentation. Our experimental evaluations show that the suggested architecture produces good segmentation results on publicly available datasets. Furthermore, ResUNet++ significantly outperforms U-Net and ResUNet, two key state-of-the-art deep learning architectures, by achieving high evaluation scores with a dice coefficient of 81.33\%, and a mean Intersection over Union (mIoU) of 79.27\% for the Kvasir-SEG dataset and a dice coefficient of 79.55\%, and a mIoU of 79.62\% with CVC-612 dataset.},
	keywords = {colonoscopy, deep learning, health informatics, Medical image segmentation, Polyp segmentation, Semantic segmentation},
	author = {Jha, Debesh and Pia H. {Smedsrud} and Riegler, Michael and Johansen, Dag and de Lange, Thomas and Halvorsen, P{\r a}l and H{\r a}vard D {Johansen}}
}
@misc {25795,
	title = {Automatic Detection of Angiectasia: Evaluation of Deep Learning and Handcrafted Approaches},
	howpublished = { IEEE Conference on Biomedical and Health Informatics (BHI) 2018},
	year = {2018},
	abstract = {Angiectasia, formerly called angiodysplasia, is one of the most frequent vascular lesions and often the cause of gastrointestinal bleedings. Medical specialists assessing videos of examinations reach a detection performance of 16\% for the detection of bleeding to 69\% for the detection of angiectasia. In this paper, we present several machine-learning-based approaches for angiectasia detection in wireless video capsule endoscopy images. The most promising results for pixel-wise localization and frame-wise detection are obtained by the proposed deep learning approach using generative adversarial networks (GANs) with a sensitivity of 88\% and specificity of 99.9\% for pixel-wise localization and a sensitivity of 98\% and a specificity of 100\% for frame-wise detection, which fits the requirements for automatic angiectasia detection in real clinical settings.},
	author = {Pogorelov, Konstantin and Ostroukhova, Olga and Petlund, Andreas and Halvorsen, P{\r a}l and Espeland, H{\r a}vard and Kupka, Tomas and de Lange, Thomas and Griwodz, Carsten and Riegler, Michael}
}
@inproceedings {25950,
	title = {Comprehensible Reasoning and Automated Reporting of Medical Examinations Based on Deep Learning Analysis},
	journal = {Proceedings of the 9th ACM Multimedia Systems Conference},
	year = {2018},
	pages = {490-493},
	publisher = {ACM},
	address = {Amsterdam, Netherlands},
	isbn = {978-1-4503-5192-8},
	doi = {10.1145/3204949.3208113},
	author = {Hicks, Steven and Pogorelov, Konstantin and Lux, Mathias and Jeppsson, Mattis and Kristin Ranheim {Randel} and de Lange, Thomas and Sigrun Losadal {Eskeland} and Halvorsen, P{\r a}l and Riegler, Michael}
}
@inproceedings {25794,
	title = {Deep Learning and Handcrafted Feature Based Approaches for Automatic Detection of Angiectasia},
	journal = {2018 IEEE Conference on Biomedical and Health Informatics (BHI)},
	year = {2018},
	pages = {365-368},
	publisher = {IEEE},
	abstract = {Angiectasia, formerly called angiodysplasia, is one of the most frequent vascular lesions and often the cause of gastrointestinal bleedings. Medical specialists assessing videos or images of examinations reach a detection performance of 16\% for the detection of bleeding to 69\% for the detection of angiectasia. This shows that automatic detection to support medical experts can be useful. In this paper, we present several machine learning-based approaches for angiectasia detection in wireless video capsule endoscopy frames. In summary, the most promising results for pixel-wise localization and framewise detection are obtained by the proposed deep learning method using generative adversarial networks (GANs). Using this approach, we achieve a sensitivity of 88\% and specificity of 99.9\% for pixel-wise localization, and a sensitivity of 98\% and a specificity of 100\% for frame-wise detection. Thus, the results demonstrate the capability of using deep learning for automatic angiectasia detection in real clinical settings.\&nbsp;},
	keywords = {Angiectasia, computer aided diagnosis, deep learning, Machine learning, video capsular endoscopy},
	doi = {10.1109/BHI.2018.8333444},
	author = {Pogorelov, Konstantin and Ostroukhova, Olga and Petlund, Andreas and Halvorsen, P{\r a}l and de Lange, Thomas and Espeland, H{\r a}vard and Kupka, Tomas and Griwodz, Carsten and Riegler, Michael}
}
@inproceedings {25954,
	title = {Deep Learning and Hand-crafted Feature Based Approaches for Polyp Detection in Medical Videos},
	journal = {31st IEEE CBMS International Symposium on Computer-Based Medical Systems},
	year = {2018},
	pages = {381-386},
	publisher = {IEEE},
	address = {Karlstad, Sweden},
	issn = {2372-9198},
	doi = {10.1109/CBMS.2018.00073},
	author = {Pogorelov, Konstantin and Ostroukhova, Olga and Jeppsson, Mattis and Espeland, H{\r a}vard and Griwodz, Carsten and de Lange, Thomas and Johansen, Dag and Riegler, Michael and Halvorsen, P{\r a}l}
}
@inproceedings {25956,
	title = {Dissecting Deep Neural Networks for Better Medical Image Classification and Classification Understanding},
	journal = {31st IEEE CBMS International Symposium on Computer-Based Medical Systems},
	year = {2018},
	publisher = {IEEE},
	address = {Karlstad, Sweden},
	issn = {2372-9198},
	doi = {10.1109/CBMS.2018.00070},
	author = {Hicks, Steven and Riegler, Michael and Pogorelov, Konstantin and de Lange, Thomas and Kristin Ranheim {Randel} and Kim V. {{\r A}nonsen} and Jeppsson, Mattis and Halvorsen, P{\r a}l and Sigrun Losadal {Eskeland}}
}
@inproceedings {26256,
	title = {Medico Multimedia Task at MediaEval 2018},
	journal = {Working Notes Proceedings of the MediaEval 2018 Workshop},
	year = {2018},
	publisher = {CEUR Workshop Proceedings},
	abstract = {The Medico: Multimedia for Medicine Task, running for the second time as part of MediaEval 2018, focuses on detecting abnormalities, diseases, anatomical landmarks and other findings in images captured by medical devices in the gastrointestinal tract. The task is described, including the use case and its challenges, the dataset with ground truth, the required participant runs and the evaluation metrics.},
	author = {Pogorelov, Konstantin and Riegler, Michael and Halvorsen, P{\r a}l and Hicks, Steven and Kristin Ranheim {Randel} and Dang-Nguyen, Duc-Tien and Lux, Mathias and Ostroukhova, Olga and de Lange, Thomas}
}
@article {26245,
	title = {Methodology to develop machine learning algorithms to improve performance in gastrointestinal endoscopy},
	journal = {World Journal of Gastroenterology},
	volume = {45},
	year = {2018},
	month = {12/2018},
	pages = {5057-5062},
	publisher = {Baishideng Publishing Group Inc},
	abstract = {Assisted diagnosis using artificial intelligence has been a holy grail in medical research for many years, and recent developments in computer hardware have enabled the narrower area of machine learning to equip clinicians with potentially useful tools for computer assisted diagnosis (CAD) systems. However, training and assessing a computer{\textquoteright}s ability to diagnose like a human are complex tasks, and successful outcomes depend on various factors. We have focused our work on gastrointestinal (GI) endoscopy because it is a cornerstone for diagnosis and treatment of diseases of the GI tract. About 2.8 million luminal GI (esophageal, stomach, colorectal) cancers are detected globally every year, and although substantial technical improvements in endoscopes have been made over the last 10-15 years, a major limitation of endoscopic examinations remains operator variation. This translates into a substantial inter-observer variation in the detection and assessment of mucosal lesions, causing among other things an average polyp miss-rate of 20\% in the colon and thus the subsequent development of a number of post-colonoscopy colorectal cancers. CAD systems might eliminate this variation and lead to more accurate diagnoses. In this editorial, we point out some of the current challenges in the development of efficient computer-based digital assistants. We give examples of proposed tools using various techniques, identify current challenges, and give suggestions for the development and assessment of future CAD systems.\&nbsp;},
	doi = {10.3748/wjg.v24.i45.5057},
	url = {https://www.wjgnet.com/1007-9327/abstract/v24/i45/5057.htm},
	author = {de Lange, Thomas and Halvorsen, P{\r a}l and Riegler, Michael}
}
@inproceedings {25953,
	title = {Mimir: An Automatic Reporting and Reasoning System for Deep Learning based Analysis in the Medical Domain},
	journal = {Proceedings of the 9th ACM Multimedia Systems Conference},
	year = {2018},
	pages = {369-374},
	publisher = {ACM},
	address = {Amsterdam, Netherlands},
	isbn = {978-1-4503-5192-8},
	doi = {10.1145/3204949.3208129},
	author = {Hicks, Steven and Lux, Mathias and de Lange, Thomas and Kristin Ranheim {Randel} and Jeppsson, Mattis and Pogorelov, Konstantin and Halvorsen, P{\r a}l and Riegler, Michael}
}
@inproceedings {26249,
	title = {Tradeoffs using Binary and Multiclass Neural Network Classification for Medical Multidisease Detection},
	journal = {2018 IEEE International Symposium on Multimedia (ISM)},
	year = {2018},
	month = {12/2018},
	pages = {1-8},
	publisher = {IEEE},
	abstract = {The interest in neural networks has increased sig- nificantly, and the application of this type of machine learning is vast, ranging from natural image classification to medical image segmentation. However, many users of neural networks tend to use them as a black box tool. They do not access all of the possible variations, nor take into account the respective classification accuracies and costs. In our work, we focus on multiclass image classification, and in this research, we shed light on the trade-offs between systems using a single multiclass classification and multiple binary classifiers, respectively. We have tested the these classifiers on several modern neural network architectures, including DenseNet, Inception v3, Inception ResNet v2, Xception, NASNet and MobileNet. We have compared several aspects of the performance of these architectures during training and testing using both classification styles. We have compared classification speed and several classification accuracy metrics. Here, we present the results from experiments on a total of 99 networks: 11 multiclass and 88 individual binary networks, for an 8-class classification of medical images. In short, using multiple binary classification networks resulted in a 7\% increase in the average F1 score, a 1\% increase in average accuracy, a 1\% increase in precision, and a 4\% increase in average recall. However, on average, such a multi-network style performed the classification 7.6 times slower compared to a single network multiclass implementation. These collective findings show that both approaches can be applied to modern neural network structures. Several binary networks will often give increased classification accuracy, but at the cost of classification speed and resource consumption.\&nbsp;},
	doi = {10.1109/ISM.2018.00009},
	author = {Tor Jan Derek {Berstad} and Riegler, Michael and Espeland, H{\r a}vard and de Lange, Thomas and Pia H. {Smedsrud} and Pogorelov, Konstantin and H{\r a}kon Kvale {Stensland} and Halvorsen, P{\r a}l}
}
@inproceedings {25628,
	title = {A comparison of deep learning with global features for gastrointestinal disease detection},
	journal = {MediaEval Benchmark 2017},
	year = {2017},
	month = {09/2017},
	publisher = {CEUR-WS.org},
	address = {Dublin, Ireland},
	author = {Pogorelov, Konstantin and Riegler, Michael and Halvorsen, P{\r a}l and Griwodz, Carsten and de Lange, Thomas and Kristin Ranheim {Randel} and Sigrun Losada {Eskeland} and Dang-Nguyen, Duc-Tien and Olga, Ostroukhova and Lux, Mathias and Spampinato, Concetto},
	editor = {Riegler, Michael}
}
@article {25462,
	title = {Efficient disease detection in gastrointestinal videos {\textendash} global features versus neural networks},
	journal = {Multimedia Tools and Applications},
	volume = {76},
	year = {2017},
	month = {11/2017},
	pages = {22493{\textendash}22525},
	publisher = {ACM/Springer},
	abstract = {Analysis of medical videos from the human gastrointestinal (GI) tract for detection and localization of abnormalities like lesions and diseases requires both high precision and recall. Additionally, it is important to support efficient, real-time processing for live feedback during (i) standard colonoscopies and (ii) scalability for massive population-based screening, which we conjecture can be done using a wireless video capsule endoscope (camera-pill). Existing related work in this field does neither provide the necessary combination of accuracy and performance for detecting multiple classes of abnormalities simultaneously nor for particular disease localization tasks. In this paper, a complete end-to-end multimedia system is presented where the aim is to tackle automatic analysis of GI tract videos. The system includes an entire pipeline ranging from data collection, processing and analysis, to visualization. The system combines deep learning neural networks, information retrieval, and analysis of global and local image features in order to implement multi-class classification, detection and localization. Furthermore, it is built in a modular way, so that it can be easily extended to deal with other types of abnormalities. Simultaneously, the system is developed for efficient processing in order to provide real-time feedback to the doctors and for scalability reasons when potentially applied for massive population-based algorithmic screenings in the future. Initial experiments show that our system has multiclass detection accuracy and polyp localization precision at least as good as state-of-the-art systems, and provides additional novelty in terms of real-time performance, low resource consumption and ability to extend with support for new classes of diseases.},
	keywords = {Algorithmic screening, Automatic disease detection, Deep learning neural networks, Global and local image features, Information retrieval, Medical, performance evaluation},
	issn = {1380-7501},
	doi = {10.1007/s11042-017-4989-y},
	url = {https://link.springer.com/article/10.1007\%2Fs11042-017-4989-y},
	author = {Pogorelov, Konstantin and Riegler, Michael and Sigrun Losada {Eskeland} and de Lange, Thomas and Johansen, Dag and Griwodz, Carsten and Peter Thelin {Schmidt} and Halvorsen, P{\r a}l}
}
@inproceedings {25338,
	title = {EIR: changing the scene of automatic detection software for gastrointestinal endoscopy},
	journal = {World Congress of GI Endoscopy},
	year = {2017},
	month = {02/2017},
	publisher = {World Endoscopic Organisation},
	address = {Hyderabad, India},
	author = {Sigrun L. {Eskeland} and Aabakken, Lars and Riegler, Michael and Pogorelov, Konstantin and Peter Thelin {Schmidt} and Johansen, Dag and Halvorsen, P{\r a}l},
	editor = {de Lange, Thomas}
}
@article {25265,
	title = {From Annotation to Computer-Aided Diagnosis: Detailed Evaluation of a Medical Multimedia System},
	journal = {ACM Transactions on Multimedia Computing, Communications, and Applications},
	volume = {13},
	year = {2017},
	publisher = {ACM},
	author = {Riegler, Michael and Pogorelov, Konstantin and Sigrun L. {Eskeland} and Peter Thelin {Schmidt} and Albisser, Zeno and Johansen, Dag and Griwodz, Carsten and Halvorsen, P{\r a}l and de Lange, Thomas}
}
@inproceedings {25433,
	title = {A Holistic Multimedia System for Gastrointestinal Tract Disease Detection},
	journal = {8th annual ACM conference on Multimedia Systems (MMSys)},
	year = {2017},
	month = {06/2017},
	pages = {112-123},
	publisher = {ACM},
	abstract = {Analysis of medical videos for detection of abnormalities and diseases requires both high precision and recall, but also real-time processing for live feedback and scalability for massive screening of entire populations. Existing work on this field does not provide the necessary combination of retrieval accuracy and performance.\&nbsp;In this paper, a multimedia system is presented where the aim is to tackle automatic analysis of videos from the human gastrointestinal (GI) tract. The system includes the whole pipeline from data collection, processing and analysis, to visualization. The system combines filters using machine learning, image recognition and extraction of global and local image features. Furthermore, it is built in a modular way so that it can easily be extended. At the same time, it is developed for efficient processing in order to provide real-time feedback to the doctors. Our experimental evaluation proves that our system has detection and localisation accuracy at least as good as existing systems for polyp detection, it is capable of detecting a wider range of diseases, it can analyze video in real-time, and it has a low resource consumption for scalability.},
	isbn = {978-1-4503-5002-0},
	doi = {10.1145/3083187.3083189},
	url = {http://dl.acm.org/citation.cfm?id=3083189},
	author = {Pogorelov, Konstantin and Sigrun Losadal {Eskeland} and de Lange, Thomas and Griwodz, Carsten and Kristin Ranheim {Randel} and H{\r a}kon Kvale {Stensland} and Dang-Nguyen, Duc-Tien and Spampinato, Concetto and Johansen, Dag and Riegler, Michael and Halvorsen, P{\r a}l},
	editor = {Cesar, Pablo and Hsu, Cheng-hsin}
}
@inproceedings {25332,
	title = {Kvasir: A Multi-Class Image-Dataset for Computer Aided Gastrointestinal Disease Detection},
	journal = {ACM Multimedia Systems},
	year = {2017},
	month = {07/2017},
	publisher = {ACM},
	address = {Taiwan},
	author = {Pogorelov, Konstantin and Ranheim, Kristin and Griwodz, Carsten and de Lange, Thomas and Sigrun L. {Eskeland} and Johansen, Dag and Peter Thelin {Schmidt} and Spampinato, Concetto and Dang-Nguyen, Duc-Tien and Lux, Mathias and Riegler, Michael and Halvorsen, P{\r a}l}
}
@inproceedings {25627,
	title = {Multimedia for medicine: the medico Task at mediaEval 2017},
	journal = {MediaEval Benchmark 2017},
	year = {2017},
	month = {09/2017},
	publisher = {CEUR-WS.org},
	address = {Dublin, Ireland},
	author = {Riegler, Michael and Pogorelov, Konstantin and Halvorsen, P{\r a}l and Griwodz, Carsten and de Lange, Thomas and Kristin Ranheim {Randel} and Sigrun Losada {Eskeland} and Dang-Nguyen, Duc-Tien and Lux, Mathias and Spampinato, Concetto},
	editor = {Riegler, Michael}
}
@inproceedings {25333,
	title = {Nerthus: A Bowel Preparation Quality Video Dataset},
	journal = {ACM Multimedia Systems},
	year = {2017},
	publisher = {ACM},
	address = {Taipei},
	author = {Pogorelov, Konstantin and Ranheim, Kristin and de Lange, Thomas and Sigrun L. {Eskeland} and Johansen, Dag and Griwodz, Carsten and Spampinato, Concetto and Taschwer, Mario and Lux, Mathias and Peter Thelin {Schmidt} and Riegler, Michael and Halvorsen, P{\r a}l}
}
@inproceedings {24472,
	title = {Computer Aided Disease Detection System for Gastrointestinal Examinations},
	journal = {Multimedia Systems Conference 2016},
	year = {2016},
	month = {05/2016},
	publisher = {ACM},
	address = {New York},
	author = {Riegler, Michael and Pogorelov, Konstantin and Markussen, Jonas and Lux, Mathias and H{\r a}kon Kvale {Stensland} and de Lange, Thomas and Griwodz, Carsten and Halvorsen, P{\r a}l and Johansen, Dag and Peter Thelin {Schmidt} and Sigrun L. {Eskeland}}
}
@inproceedings {24474,
	title = {Efficient Processing of Videos in a Multi Auditory Environment Using Device Lending of GPUs},
	journal = {The 7th International Conference on Multimedia Systems (MMSys)},
	year = {2016},
	month = {05/2016},
	pages = {36:1-36:4},
	publisher = {ACM},
	isbn = {978-1-4503-4297-1},
	doi = {10.1145/2910017.2910636},
	author = {Pogorelov, Konstantin and Riegler, Michael and Markussen, Jonas and H{\r a}kon Kvale {Stensland} and Halvorsen, P{\r a}l and Griwodz, Carsten and Sigrun L. {Eskeland} and de Lange, Thomas}
}
@inproceedings {24482,
	title = {EIR - Efficient Computer Aided Diagnosis Framework for Gastrointestinal Endoscopies},
	journal = {International Workshop on Content-based Multimedia Indexing},
	year = {2016},
	month = {06/2016},
	publisher = {IEEE / ACM},
	author = {Riegler, Michael and Pogorelov, Konstantin and Halvorsen, P{\r a}l and de Lange, Thomas and Griwodz, Carsten and Johansen, Dag and Peter Thelin {Schmidt} and Sigrun L. {Eskeland}}
}
@inproceedings {24481,
	title = {Explorative Hyperbolic-Tree-Based Clustering Tool for Unsupervised Knowledge Discovery},
	journal = {International Workshop on Content-based Multimedia Indexing},
	year = {2016},
	month = {06/2016},
	publisher = {IEEE / ACM},
	author = {Riegler, Michael and Pogorelov, Konstantin and Lux, Mathias and Halvorsen, P{\r a}l and Griwodz, Carsten and Sigrun L. {Eskeland} and de Lange, Thomas}
}
@inproceedings {24478,
	title = {GPU-accelerated Real-time Gastrointestinal Diseases Detection},
	journal = {CBMS 2016 : The 29th International Symposium on Computer-Based Medical Systems},
	year = {2016},
	month = {07/2016},
	publisher = {IEEE},
	author = {Pogorelov, Konstantin and Riegler, Michael and Halvorsen, P{\r a}l and de Lange, Thomas and Peter Thelin {Schmidt} and Sigrun L. {Eskeland} and Griwodz, Carsten and Johansen, Dag}
}
@inproceedings {24641,
	title = {Multimedia and Medicine: Teammates for Better Disease Detection and Survival},
	journal = {ACM Multimedia},
	year = {2016},
	month = {10/2016},
	publisher = {ACM},
	address = {Amsterdam, The Netherlands, The Netherlands},
	doi = {http://dx.doi.org/10.1145/2964284.2976760},
	author = {Riegler, Michael and Griwodz, Carsten and Spampinato, Concetto and de Lange, Thomas and Sigrun L. {Eskeland} and Pogorelov, Konstantin and Tavanapong, Wallapak and Peter Thelin {Schmidt} and Gurrin, Cathal and Johansen, Dag and Johansen, H{\r a}vard and Halvorsen, P{\r a}l}
}
