Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
AI Medical Service Inc., Tokyo, Japan.
Dig Endosc. 2020 Mar;32(3):382-390. doi: 10.1111/den.13507. Epub 2019 Oct 2.
BACKGROUND AND AIM: Although small-bowel angioectasia is reported as the most common cause of bleeding in patients and frequently diagnosed by capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding, a computer-aided detection method has not been established. We developed an artificial intelligence system with deep learning that can automatically detect small-bowel angioectasia in CE images. METHODS: We trained a deep convolutional neural network (CNN) system based on Single Shot Multibox Detector using 2237 CE images of angioectasia. We assessed its diagnostic accuracy by calculating the area under the receiver operating characteristic curve (ROC-AUC), sensitivity, specificity, positive predictive value, and negative predictive value using an independent test set of 10 488 small-bowel images, including 488 images of small-bowel angioectasia. RESULTS: The AUC to detect angioectasia was 0.998. Sensitivity, specificity, positive predictive value, and negative predictive value of CNN were 98.8%, 98.4%, 75.4%, and 99.9%, respectively, at a cut-off value of 0.36 for the probability score. CONCLUSIONS: We developed and validated a new system based on CNN to automatically detect angioectasia in CE images. This may be well applicable to daily clinical practice to reduce the burden of physicians as well as to reduce oversight.
背景与目的:尽管小肠血管扩张症被报道为导致出血的最常见原因,并且在不明原因胃肠道出血的患者中经常通过胶囊内镜 (CE) 诊断,但尚未建立计算机辅助检测方法。我们开发了一种基于深度学习的人工智能系统,该系统可以自动检测 CE 图像中的小肠血管扩张症。
方法:我们使用 2237 张血管扩张症的 CE 图像训练了一个基于单-shot 多框检测器的深度卷积神经网络 (CNN) 系统。我们使用包括 488 张小肠血管扩张症图像在内的 10488 张小肠图像的独立测试集,通过计算接收者操作特征曲线下的面积 (ROC-AUC)、敏感性、特异性、阳性预测值和阴性预测值来评估其诊断准确性。
结果:检测血管扩张症的 AUC 为 0.998。CNN 的敏感性、特异性、阳性预测值和阴性预测值分别为 98.8%、98.4%、75.4%和 99.9%,概率评分的截断值为 0.36。
结论:我们开发并验证了一种基于 CNN 的新系统,用于自动检测 CE 图像中的血管扩张症。这可能非常适用于日常临床实践,以减轻医生的负担并减少漏诊。
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