Endoscopic prediction of submucosal invasion in Barrett's cancer with the use of artificial intelligence: a pilot study.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
09 2021
Historique:
aheadofprint: 16 11 2020
pubmed: 17 11 2020
medline: 14 9 2021
entrez: 16 11 2020
Statut: ppublish

Résumé

The accurate differentiation between T1a and T1b Barrett's-related cancer has both therapeutic and prognostic implications but is challenging even for experienced physicians. We trained an artificial intelligence (AI) system on the basis of deep artificial neural networks (deep learning) to differentiate between T1a and T1b Barrett's cancer on white-light images. Endoscopic images from three tertiary care centers in Germany were collected retrospectively. A deep learning system was trained and tested using the principles of cross validation. A total of 230 white-light endoscopic images (108 T1a and 122 T1b) were evaluated using the AI system. For comparison, the images were also classified by experts specialized in endoscopic diagnosis and treatment of Barrett's cancer. The sensitivity, specificity, F1 score, and accuracy of the AI system in the differentiation between T1a and T1b cancer lesions was 0.77, 0.64, 0.74, and 0.71, respectively. There was no statistically significant difference between the performance of the AI system and that of experts, who showed sensitivity, specificity, F1, and accuracy of 0.63, 0.78, 0.67, and 0.70, respectively. This pilot study demonstrates the first multicenter application of an AI-based system in the prediction of submucosal invasion in endoscopic images of Barrett's cancer. AI scored equally to international experts in the field, but more work is necessary to improve the system and apply it to video sequences and real-life settings. Nevertheless, the correct prediction of submucosal invasion in Barrett's cancer remains challenging for both experts and AI.

Sections du résumé

BACKGROUND
The accurate differentiation between T1a and T1b Barrett's-related cancer has both therapeutic and prognostic implications but is challenging even for experienced physicians. We trained an artificial intelligence (AI) system on the basis of deep artificial neural networks (deep learning) to differentiate between T1a and T1b Barrett's cancer on white-light images.
METHODS
Endoscopic images from three tertiary care centers in Germany were collected retrospectively. A deep learning system was trained and tested using the principles of cross validation. A total of 230 white-light endoscopic images (108 T1a and 122 T1b) were evaluated using the AI system. For comparison, the images were also classified by experts specialized in endoscopic diagnosis and treatment of Barrett's cancer.
RESULTS
The sensitivity, specificity, F1 score, and accuracy of the AI system in the differentiation between T1a and T1b cancer lesions was 0.77, 0.64, 0.74, and 0.71, respectively. There was no statistically significant difference between the performance of the AI system and that of experts, who showed sensitivity, specificity, F1, and accuracy of 0.63, 0.78, 0.67, and 0.70, respectively.
CONCLUSION
This pilot study demonstrates the first multicenter application of an AI-based system in the prediction of submucosal invasion in endoscopic images of Barrett's cancer. AI scored equally to international experts in the field, but more work is necessary to improve the system and apply it to video sequences and real-life settings. Nevertheless, the correct prediction of submucosal invasion in Barrett's cancer remains challenging for both experts and AI.

Identifiants

pubmed: 33197942
doi: 10.1055/a-1311-8570
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

878-883

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.

Auteurs

Alanna Ebigbo (A)

III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg Germany.

Robert Mendel (R)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.
Regensburg Center of Health Sciences and Technology (RCHST), OTH Regensburg, Regensburg, Germany.

Tobias Rückert (T)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.

Laurin Schuster (L)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.

Andreas Probst (A)

III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg Germany.

Johannes Manzeneder (J)

III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg Germany.

Friederike Prinz (F)

III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg Germany.

Matthias Mende (M)

Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany.

Ingo Steinbrück (I)

Department of Gastroenterology, Hepatology and Interventional Endoscopy, Asklepios Klinik Barmbek, Hamburg, Germany.

Siegbert Faiss (S)

Gastroenterology, Sana Klinikum Lichtenberg, Berlin, Germany.

David Rauber (D)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.
Regensburg Center of Biomedical Engineering (RCBE), OTH Regensburg and Regensburg University, Regensburg, Germany.

Luis A de Souza (LA)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.
Department of Computing, São Paulo State University, São Paulo, Brazil.

João P Papa (JP)

Department of Computing, São Paulo State University, São Paulo, Brazil.

Pierre H Deprez (PH)

Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium.

Tsuneo Oyama (T)

Saku Central Hospital Advanced Care Center, Nagano, Japan.

Akiko Takahashi (A)

Saku Central Hospital Advanced Care Center, Nagano, Japan.

Stefan Seewald (S)

GastroZentrum, Klinik Hirslanden, Zurich, Switzerland.

Prateek Sharma (P)

Department of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas School of Medicine, Kansas City, Missouri, United States.

Michael F Byrne (MF)

Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Christoph Palm (C)

Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg Germany.
Regensburg Center of Health Sciences and Technology (RCHST), OTH Regensburg, Regensburg, Germany.
Regensburg Center of Biomedical Engineering (RCBE), OTH Regensburg and Regensburg University, Regensburg, Germany.

Helmut Messmann (H)

III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg Germany.

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