Real-time use of artificial intelligence for diagnosing early gastric cancer by magnifying image-enhanced endoscopy: a multicenter diagnostic study (with videos)

作者:He, Xinqi; Wu, Lianlian; Dong, Zehua; Gong, Dexin; Jiang, Xiaoda; Zhang, Heng; Ai, Yaowei; Tong, Qiaoyun; Lv, Peihua; Lu, Bin; Wu, Qi; Yuan, Jingping; Xu, Ming; Yu, Honggang*
来源:Gastrointestinal Endoscopy, 2022, 95(4): 671-+.
DOI:10.1016/j.gie.2021.11.040

摘要

Background and Aims: Endoscopy is a pivotal method for detecting early gastric cancer (EGC). However, skill among endoscopists varies greatly. Here, we proposed a deep learning-based system named ENDOANGEL-ME to diagnose EGC in magnifying image-enhanced endoscopy (M-IEE). @@@ Methods: M-IEE images were retrospectively obtained from 6 hospitals in China, including 4667 images for training and validation, 1324 images for internal tests, and 4702 images for external tests. One hundred eightyseven stored videos from 2 hospitals were used to evaluate the performance of ENDOANGEL-ME and endoscopists and to assess the effect of ENDOANGEL-ME on improving the performance of endoscopists. Prospective consecutive patients undergoing M-IEE were enrolled from August 17, 2020 to August 2, 2021 in Renmin Hospital of Wuhan University to assess the applicability of ENDOANGEL-ME in clinical practice. @@@ Results: A total of 3099 patients undergoing M-IEE were enrolled in this study. The diagnostic accuracy of ENDOANGEL-ME for diagnosing EGC was 88.44% and 90.49% in internal and external images, respectively. In 93 internal videos, ENDOANGEL-ME achieved an accuracy of 90.32% for diagnosing EGC, significantly superior to that of senior endoscopists (70.16% +/- 8.78%). In 94 external videos, with the assistance of ENDOANGELME, endoscopists showed improved accuracy and sensitivity (85.64% vs 80.32% and 82.03% vs 67.19%, respectively). In 194 prospective consecutive patients with 251 lesions, ENDOANGEL-ME achieved a sensitivity of 92.59% (25/27) and an accuracy of 83.67% (210/251) in real clinical practice. @@@ Conclusions: This multicenter diagnostic study showed that ENDOANGEL-ME can be well applied in the clinical setting.

  • 单位
    华中科技大学; 武汉大学