EndoFinder: Online Lesion Retrieval for Explainable Colorectal Polyp Diagnosis Leveraging Latent Scene Representations

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality, underscoring the importance of timely polyp detection and diagnosis. While deep learning models have improved optical-assisted diagnostics, they often demand extensive labeled datasets and yield "black-box" outputs with limited interpretability. In this paper, we propose EndoFinder, an online polyp retrieval framework that leverages multi-view scene representations for explainable and scalable CRC diagnosis. First, we develop a Polyp-aware Image Encoder by combining contrastive learning and a reconstruction task, guided by polyp segmentation masks. This self-supervised approach captures robust features without relying on large-scale annotated data. Next, we treat each polyp as a three-dimensional "scene" and introduce a Scene Representation Transformer, which fuses multiple views of the polyp into a single latent representation. By discretizing this representation through a hashing layer, EndoFinder enables real-time retrieval from a compiled database of historical polyp cases, where diagnostic information serves as interpretable references for new queries. We evaluate EndoFinder on both public and newly collected polyp datasets for re-identification and pathology classification. Results show that EndoFinder outperforms existing methods in accuracy while providing transparent, retrieval-based insights for clinical decision-making. By contributing a novel dataset and a scalable, explainable framework, our work addresses key challenges in polyp diagnosis and offers a promising direction for more efficient AI-driven colonoscopy workflows. The source code is available at https://github.com/ku262/EndoFinder-Scene.