Tamai Naoto, Saito Yutaka, Sakamoto Taku, Nakajima Takeshi, Matsuda Takahisa, Sumiyama Kazuki, Tajiri Hisao, Koyama Ryosuke, Kido Shoji
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Endosc Int Open. 2017 Aug;5(8):E690-E694. doi: 10.1055/s-0043-105490. Epub 2017 Aug 3.
Magnifying narrow-band imaging (M-NBI) enables detailed observation of microvascular architecture and can be used in endoscopic diagnosis of colorectal lesion. However, in clinical practice, differential diagnosis and estimation of invasion depth of colorectal lesions based on M-NBI findings require experience. Therefore, developing computer-aided diagnosis (CAD) for M-NBI would be beneficial for clinical practice. The aim of this study was to evaluate the effectiveness of software for CAD of colorectal lesions.
In collaboration with Yamaguchi University, we developed novel software that enables CAD of colorectal lesions using M-NBI images. This software for CAD further specifically divides original Sano's colorectal M-NBI classification into 3 groups (group A, capillary pattern [CP] type I; group B, CP type II + CP type IIIA; group C, CP type IIIB), which describe hyperplastic polyps (HPs), adenoma/adenocarcinoma (intramucosal [IM] to submucosal [SM]-superficial) lesions, and SM-deep lesions, respectively. We retrospectively reviewed 121 lesions evaluated using M-NBI.
The 121 reviewed lesions included 21 HP, 80 adenoma/adenocarcinoma (IM to SM-superficial), and 20 SM-deep lesions. The concordance rate between the CAD and the diagnosis of the experienced endoscopists was 90.9 %. The sensitivity, specificity, positive and negative predictive values, and accuracy of the CAD for neoplastic lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively. The values for SM-deep lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively.
Relatively high diagnostic values were obtained using CAD. This software for CAD could possibly lead to a wider use of M-NBI in the endoscopic diagnosis of colorectal lesions.
放大窄带成像(M-NBI)能够详细观察微血管结构,可用于大肠病变的内镜诊断。然而,在临床实践中,基于M-NBI表现对大肠病变进行鉴别诊断和浸润深度评估需要经验。因此,开发用于M-NBI的计算机辅助诊断(CAD)将对临床实践有益。本研究的目的是评估用于大肠病变CAD的软件的有效性。
我们与山口大学合作,开发了一种能够使用M-NBI图像对大肠病变进行CAD的新型软件。该CAD软件进一步将原来的佐野大肠M-NBI分类具体分为3组(A组,毛细血管形态[CP]I型;B组,CP II型+CP IIIA型;C组,CP IIIB型),分别描述增生性息肉(HPs)、腺瘤/腺癌(黏膜内[IM]至黏膜下[SM]-浅表)病变和SM-深部病变。我们回顾性分析了121例使用M-NBI评估的病变。
121例回顾性分析的病变包括21例HP、80例腺瘤/腺癌(IM至SM-浅表)和20例SM-深部病变。CAD与经验丰富的内镜医师诊断之间的符合率为90.9%。CAD对肿瘤性病变的敏感性、特异性、阳性和阴性预测值及准确性分别为83.9%、82.6%、53.1%、95.6%和82.8%。SM-深部病变的相应值分别为83.9%、82.6%、53.1%、95.6%和82.8%。
使用CAD获得了相对较高的诊断价值。这种CAD软件可能会使M-NBI在大肠病变的内镜诊断中得到更广泛的应用。