COMPUTER-AIDED DIAGNOSIS IMPROVES CHARACTERIZATION OF BARRETT'S NEOPLASIA BY GENERAL ENDOSCOPISTS.

BONS-AI Barrett’s OesophaguS Imaging for Artificial Intelligence

Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
16 Apr 2024
Historique:
received: 05 09 2023
revised: 25 01 2024
accepted: 08 04 2024
medline: 19 4 2024
pubmed: 19 4 2024
entrez: 18 4 2024
Statut: aheadofprint

Résumé

Characterization of visible abnormalities in Barrett esophagus (BE) patients can be challenging, especially for unexperienced endoscopists. This results in suboptimal diagnostic accuracy and poor inter-observer agreement. Computer-aided diagnosis (CADx) systems may assist endoscopists. We aimed to develop, validate and benchmark a CADx system for BE neoplasia. The CADx system received pretraining with ImageNet with consecutive domain-specific pretraining with GastroNet which includes 5 million endoscopic images. It was subsequently trained and internally validated using 1,758 narrow-band imaging (NBI) images of early BE neoplasia (352 patients) and 1,838 NBI images of non-dysplastic BE (173 patients) from 8 international centers. CADx was tested prospectively on corresponding image and video test sets with 30 cases (20 patients) of BE neoplasia and 60 cases (31 patients) of non-dysplastic BE. The test set was benchmarked by 44 general endoscopists in two phases (phase 1: no CADx assistance; phase 2: with CADx assistance). Ten international BE experts provided additional benchmark performance. Stand-alone sensitivity and specificity of the CADx system were 100% and 98% for images and 93% and 96% for videos, respectively. CADx outperformed general endoscopists without CADx assistance in terms of sensitivity (p=0.04). Sensitivity and specificity of general endoscopist increased from 84% to 96% and 90 to 98% with CAD assistance (p<0.001), respectively. CADx assistance increased endoscopists' confidence in characterization (p<0.001). CADx performance was similar to Barrett experts. CADx assistance significantly increased characterization performance of BE neoplasia by general endoscopists to the level of expert endoscopists. The use of this CADx system may thereby improve daily Barrett surveillance.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
Characterization of visible abnormalities in Barrett esophagus (BE) patients can be challenging, especially for unexperienced endoscopists. This results in suboptimal diagnostic accuracy and poor inter-observer agreement. Computer-aided diagnosis (CADx) systems may assist endoscopists. We aimed to develop, validate and benchmark a CADx system for BE neoplasia.
METHODS METHODS
The CADx system received pretraining with ImageNet with consecutive domain-specific pretraining with GastroNet which includes 5 million endoscopic images. It was subsequently trained and internally validated using 1,758 narrow-band imaging (NBI) images of early BE neoplasia (352 patients) and 1,838 NBI images of non-dysplastic BE (173 patients) from 8 international centers. CADx was tested prospectively on corresponding image and video test sets with 30 cases (20 patients) of BE neoplasia and 60 cases (31 patients) of non-dysplastic BE. The test set was benchmarked by 44 general endoscopists in two phases (phase 1: no CADx assistance; phase 2: with CADx assistance). Ten international BE experts provided additional benchmark performance.
RESULTS RESULTS
Stand-alone sensitivity and specificity of the CADx system were 100% and 98% for images and 93% and 96% for videos, respectively. CADx outperformed general endoscopists without CADx assistance in terms of sensitivity (p=0.04). Sensitivity and specificity of general endoscopist increased from 84% to 96% and 90 to 98% with CAD assistance (p<0.001), respectively. CADx assistance increased endoscopists' confidence in characterization (p<0.001). CADx performance was similar to Barrett experts.
CONCLUSION CONCLUSIONS
CADx assistance significantly increased characterization performance of BE neoplasia by general endoscopists to the level of expert endoscopists. The use of this CADx system may thereby improve daily Barrett surveillance.

Identifiants

DOI: 10.1016/j.gie.2024.04.013 PMID: 38636819
pubmed: 38636819
pii: S0016-5107(24)00233-5
doi: 10.1016/j.gie.2024.04.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Alaa Alkhalaf (A)
Lorenza Alvarez Herrero (LA)
Francisco Baldaque-Silva (F)
Maximilien Barret (M)
Jacques J Bergman (JJ)
Torsten Beyna (T)
Raf Bisschops (R)
Tim G Boers (TG)
Wouter Curvers (W)
Pierre H Deprez (PH)
Lucas C Duits (LC)
Peter Elbe (P)
Jose Miguel Esteban (JM)
Gary W Falk (GW)
Kiki N Fockens (KN)
Gregory G Ginsberg (GG)
Albert J de Groof (AJ)
Rehan Haidry (R)
Martin H Houben (MH)
Anthony Infantolino (A)
Prasad G Iyer (PG)
Martijn Jong (M)
Pieter-Jan de Jonge (PJ)
Jelmer B Jukema (JB)
Arjun Koch (A)
Srinadh Komanduri (S)
Vani Konda (V)
Koen C Kusters (KC)
Philippe Leclerq (P)
Cadman L Leggett (CL)
Charles J Lightdale (CJ)
Rosalie C Mallant-Hent (RC)
Guiomar Moral Villarejo (GM)
V Raman Muthusamy (VR)
Jacobo Ortiz Fernández-Sordo (JO)
Oliver Pech (O)
Ian Penman (I)
Roos E Pouw (RE)
Joost A van der Putten (JA)
Krish Ragunath (K)
Pieter Scholten (P)
Stefan Seewald (S)
Amritha Sethi (A)
Michael S Smith (MS)
Fons van der Sommen (F)
Arvind Trindade (A)
Sachin Wani (S)
Irving Waxman (I)
Jessie Westerhof (J)
Bas L Weusten (BL)
Peter H de With (PH)
Herbert C Wolfsen (HC)

Informations de copyright

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Jelmer B Jukema (JB)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Carolus H J Kusters (CHJ)

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

Martijn R Jong (MR)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Kiki N Fockens (KN)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Tim Boers (T)

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

Joost A van der Putten (JA)

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

Roos E Pouw (RE)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Lucas C Duits (LC)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

BasL A M Weusten (BAM)

Department of Gastroenterology and Hepatology, UMC Utrecht, University of Utrecht, Utrecht, the Netherlands; Department of Gastroenterology and Hepatology, Sint Antonius hospital, Nieuwegein, the Netherlands.

Lorenza Alvarez Herrero (LA)

Department of Gastroenterology and Hepatology, Sint Antonius hospital, Nieuwegein, the Netherlands.

Martin H M G Houben (MHMG)

Department of Gastroenterology and Hepatology, HagaZiekenhuis Den Haag, Den Haag, the Netherlands.

Wouter B Nagengast (WB)

Department of Gastroenterology and Hepatology, UMC Groningen, University of Groningen, Groningen, the Netherlands.

Jessie Westerhof (J)

Department of Gastroenterology and Hepatology, UMC Groningen, University of Groningen, Groningen, the Netherlands.

Alaa Alkhalaf (A)

Department of Gastroenterology and Hepatology, Isala Hospital Zwolle, Zwolle, the Netherlands.

Rosalie Mallant-Hent (R)

Department of Gastroenterology and Hepatology, Flevoziekenhuis Almere, Almere, the Netherlands.

Pieter Scholten (P)

Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.

Krish Ragunath (K)

Department of Gastroenterology and Hepatology, Royal Perth Hospital, Curtin University, Perth, Australia.

Stefan Seewald (S)

Department of Gastroenterology and Hepatology, Hirslanden Klinik, Zurich, Switzerland.

Peter Elbe (P)

Department of Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden; Division of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.

Francisco Baldaque Silva (FB)

Department of Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden; Center for Advanced Endoscopy Carlos Moreira da Silva, Gastroenterology Department, Pedro Hispano Hospital, ULSM Matosinhos, Portugal.

Maximilien Barret (M)

Department of Gastroenterology and Hepatology, Cochin hospital Paris, Paris, France.

Jacobo Ortiz Fernández-Sordo (JO)

Department of Gastroenterology and Hepatology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.

Guiomar Moral Villarejo (GM)

Department of Gastroenterology and Hepatology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.

Oliver Pech (O)

Department of Gastroenterology and Hepatology, St. John of God Hospital, Regensburg, Germany.

Torsten Beyna (T)

Department of Gastroenterology and Hepatology, Evangalisches Krankenhaus Düsseldorf, Düsseldorf, Germany.

Nahid S M Montazeri (NSM)

Biostatistics Unit, Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Fons van der Sommen (F)

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

Peter H de With (PH)

Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.

A Jeroen de Groof (AJ)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Jacques J Bergman (JJ)

Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: j.j.bergman@amsterdamumc.nl.

Classifications MeSH