Department of Gastroenterology, São João University Hospital, Porto, Portugal.
WGO Gastroenterology and Hepatology Training Center, Porto, Portugal.
Tech Coloproctol. 2021 Nov;25(11):1243-1248. doi: 10.1007/s10151-021-02517-5. Epub 2021 Sep 9.
BACKGROUND: Colon capsule endoscopy (CCE) is a minimally invasive alternative for patients unwilling to undergo conventional colonoscopy, or for whom the latter exam is contraindicated. This is particularly important in the setting of colorectal cancer screening. Nevertheless, these exams produce large numbers of images, and reading them is a monotonous and time-consuming task, with the risk of overlooking important lesions. The development of automated tools based on artificial intelligence (AI) technology may improve some of the drawbacks of this diagnostic instrument. METHODS: A database of CCE images was used for development of a Convolutional Neural Network (CNN) model. This database included anonymized images of patients with protruding lesions in the colon or patients with normal colonic mucosa or with other pathologic findings. A total of 3,387,259 frames from 24 CCE exams were retrospectively reviewed. For CNN development, 3640 images (860 protruding lesions and 2780 with normal mucosa or other findings) were ultimately extracted. Training and validation datasets were constructed for the development and testing of the CNN. RESULTS: The CNN detected protruding lesions with a sensitivity, specificity, positive and negative predictive values of 90.7, 92.6, 79.2 and 96.9%, respectively. The area under the receiver operating characteristic curve for detection of protruding lesions was 0.97. CONCLUSIONS: The deep learning algorithm we developed is capable of accurately detecting protruding lesions. The application of AI technology to CCE may increase its diagnostic accuracy and acceptance for screening of colorectal neoplasia.
背景:结肠胶囊内镜(CCE)是一种微创替代方法,适用于不愿意接受传统结肠镜检查或不适合后者检查的患者。在结直肠癌筛查中尤为重要。然而,这些检查会产生大量的图像,阅读这些图像是一项单调且耗时的任务,存在遗漏重要病变的风险。基于人工智能(AI)技术的自动化工具的开发可能会改善该诊断仪器的一些缺点。
方法:使用 CCE 图像数据库来开发卷积神经网络(CNN)模型。该数据库包括结肠有突出病变的患者、结肠黏膜正常的患者或有其他病理发现的患者的匿名图像。回顾性地分析了 24 次 CCE 检查中的 3387259 个帧。为了开发 CNN,最终提取了 3640 个图像(860 个突出病变和 2780 个正常黏膜或其他发现)。构建了训练和验证数据集,用于开发和测试 CNN。
结果:CNN 检测到突出病变的灵敏度、特异性、阳性和阴性预测值分别为 90.7%、92.6%、79.2%和 96.9%。检测突出病变的受试者工作特征曲线下面积为 0.97。
结论:我们开发的深度学习算法能够准确检测出突出病变。人工智能技术在 CCE 中的应用可能会提高其对结直肠肿瘤筛查的诊断准确性和接受程度。
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