Saraiva Miguel Mascarenhas, Ribeiro Tiago, González-Haba Mariano, Agudo Castillo Belén, Ferreira João P S, Vilas Boas Filipe, Afonso João, Mendes Francisco, Martins Miguel, Cardoso Pedro, Pereira Pedro, Macedo Guilherme
Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal.
WGO Gastroenterology and Hepatology Training Center, 4200-319 Porto, Portugal.
Cancers (Basel). 2023 Oct 1;15(19):4827. doi: 10.3390/cancers15194827.
Digital single-operator cholangioscopy (D-SOC) has enhanced the ability to diagnose indeterminate biliary strictures (BSs). Pilot studies using artificial intelligence (AI) models in D-SOC demonstrated promising results. Our group aimed to develop a convolutional neural network (CNN) for the identification and morphological characterization of malignant BSs in D-SOC. A total of 84,994 images from 129 D-SOC exams in two centers (Portugal and Spain) were used for developing the CNN. Each image was categorized as either a normal/benign finding or as malignant lesion (the latter dependent on histopathological results). Additionally, the CNN was evaluated for the detection of morphologic features, including tumor vessels and papillary projections. The complete dataset was divided into training and validation datasets. The model was evaluated through its sensitivity, specificity, positive and negative predictive values, accuracy and area under the receiver-operating characteristic and precision-recall curves (AUROC and AUPRC, respectively). The model achieved a 82.9% overall accuracy, 83.5% sensitivity and 82.4% specificity, with an AUROC and AUPRC of 0.92 and 0.93, respectively. The developed CNN successfully distinguished benign findings from malignant BSs. The development and application of AI tools to D-SOC has the potential to significantly augment the diagnostic yield of this exam for identifying malignant strictures.
数字单操作者胆管镜检查(D-SOC)提高了诊断不明原因胆管狭窄(BSs)的能力。在D-SOC中使用人工智能(AI)模型的初步研究显示出了有前景的结果。我们团队旨在开发一种卷积神经网络(CNN),用于在D-SOC中识别恶性BSs并进行形态学特征描述。来自葡萄牙和西班牙两个中心的129例D-SOC检查的总共84,994张图像被用于开发CNN。每张图像被分类为正常/良性发现或恶性病变(后者取决于组织病理学结果)。此外,还评估了CNN对包括肿瘤血管和乳头状突起在内的形态学特征的检测能力。完整的数据集被分为训练集和验证集。通过其敏感性、特异性、阳性和阴性预测值、准确性以及受试者操作特征曲线和精确召回率曲线下面积(分别为AUROC和AUPRC)对模型进行评估。该模型的总体准确率达到82.9%,敏感性为83.5%,特异性为82.4%,AUROC和AUPRC分别为0.92和0.93。所开发的CNN成功地区分了良性发现和恶性BSs。将AI工具开发并应用于D-SOC有可能显著提高该检查在识别恶性狭窄方面的诊断率。