Real-time artificial intelligence for detecting focal lesions and diagnosing neoplasms of the stomach by white-light endoscopy (with videos)

作者：Wu, Lianlian; Xu, Ming; Jiang, Xiaoda; He, Xinqi; Zhang, Heng; Ai, Yaowei; Tong, Qiaoyun; Lv, Peihua; Lu, Bin; Guo, Mingwen; Huang, Manling; Ye, Liping; Shen, Lei^*; Yu, Honggang^*

来源：Gastrointestinal Endoscopy, 2022, 95(2): 269-+.

DOI：10.1016/j.gie.2021.09.017

• UPPER GASTROINTESTINAL ENDOSCOPY
• CONVOLUTIONAL NEURAL-NETWORK
• COMPUTER-AIDED DETECTION
• EARLY GASTRIC-CANCER
• EUROPEAN-SOCIETY

Background and Aims: White-light endoscopy (WLE) is the most pivotal tool to detect gastric cancer in an early stage. However, the skill among endoscopists varies greatly. Here, we aim to develop a deep learning-based system named ENDOANGEL-LD (lesion detection) to assist in detecting all focal gastric lesions and predicting neoplasms by WLE. @@@ Methods: Endoscopic images were retrospectively obtained from Renmin Hospital of Wuhan University (RHWU) for the development, validation, and internal test of the system. Additional external tests were conducted in 5 other hospitals to evaluate the robustness. Stored videos from RHWU were used for assessing and comparing the performance of ENDOANGEL-LD with that of experts. Prospective consecutive patients undergoing upper endoscopy were enrolled from May 6, 2021 to August 2, 2021 in RHWU to assess clinical practice applicability. @@@ Results: Over 10,000 patients undergoing upper endoscopy were enrolled in this study. The sensitivities were 96.9% and 95.6% for detecting gastric lesions and 92.9% and 91.7% for diagnosing neoplasms in internal and external patients, respectively. In 100 videos, ENDOANGEL-LD achieved superior sensitivity and negative predictive value for detecting gastric neoplasms from that of experts (100% vs 85.5% +/- 3.4% [P = .003] and 100% vs 86.4% +/- 2.8% [P = .002], respectively). In 2010 prospective consecutive patients, ENDOANGEL-LD achieved a sensitivity of 92.8% for detecting gastric lesions with 3.04 +/- 3.04 false positives per gastroscopy and a sensitivity of 91.8% and specificity of 92.4% for diagnosing neoplasms. @@@ Conclusions: Our results show that ENDOANGEL-LD has great potential for assisting endoscopists in screening gastric lesions and suspicious neoplasms in clinical work.

• 单位
  1; 武汉大学; 华中科技大学