Colorectal cancer screening through colonoscopy continues to be the dominant global standard, as it allows identifying pre-cancerous or adenomatous lesions and provides the ability to remove them during the procedure itself. Nevertheless, failure by the endoscopist to identify such lesions increases the likelihood of lesion progression to subsequent colorectal cancer. Ultimately, colonoscopy remains operator-dependent, and the wide range of quality in colonoscopy examinations among endoscopists is influenced by variations in their technique, training, and diligence. This paper presents a novel real-time navigation guidance system for Optical Colonoscopy (OC). Our proposed system employs a real-time approach that displays both an unfolded representation of the colon and a local indicator directing to un-inspected areas. These visualizations are presented to the physician during the procedure, providing actionable and comprehensible guidance to un-surveyed areas in real-time, while seamlessly integrating into the physician's workflow. Through coverage experimental evaluation, we demonstrated that our system resulted in a higher polyp recall (PR) and high inter-rater reliability with physicians for coverage prediction. These results suggest that our real-time navigation guidance system has the potential to improve the quality and effectiveness of Optical Colonoscopy and ultimately benefit patient outcomes.

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