Chinese PLA Medical School, Beijing, 100853, PR China; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, PR China.
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, PR China.
Dig Liver Dis. 2024 Oct;56(10):1738-1745. doi: 10.1016/j.dld.2024.04.023. Epub 2024 May 13.
This study presents a novel computer-aided diagnosis (CADx) designed for optically diagnosing colorectal polyps using white light imaging (WLI).We aimed to evaluate the effectiveness of the CADx and its auxiliary role among endoscopists with different levels of expertise.
We collected 2,324 neoplastic and 3,735 nonneoplastic polyp WLI images for model training, and 838 colorectal polyp images from 740 patients for model validation. We compared the diagnostic accuracy of the CADx with that of 15 endoscopists under WLI and narrow band imaging (NBI). The auxiliary benefits of CADx for endoscopists of different experience levels and for identifying different types of colorectal polyps was also evaluated.
The CADx demonstrated an optical diagnostic accuracy of 84.49%, showing considerable superiority over all endoscopists, irrespective of whether WLI or NBI was used (P < 0.001). Assistance from the CADx significantly improved the diagnostic accuracy of the endoscopists from 68.84% to 77.49% (P = 0.001), with the most significant impact observed among novice endoscopists. Notably, novices using CADx-assisted WLI outperform junior and expert endoscopists without such assistance.
The CADx demonstrated a crucial role in substantially enhancing the precision of optical diagnosis for colorectal polyps under WLI and showed the greatest auxiliary benefits for novice endoscopists.
本研究提出了一种新的计算机辅助诊断(CADx)系统,旨在使用白光成像(WLI)对结直肠息肉进行光学诊断。我们旨在评估 CADx 的有效性及其在不同专业水平的内镜医师中的辅助作用。
我们收集了 2324 个肿瘤性和 3735 个非肿瘤性息肉的 WLI 图像用于模型训练,以及 740 名患者的 838 个结直肠息肉图像用于模型验证。我们比较了 CADx 在 WLI 和窄带成像(NBI)下与 15 名内镜医师的诊断准确性。还评估了 CADx 对不同经验水平的内镜医师和不同类型结直肠息肉的辅助作用。
CADx 的光学诊断准确率为 84.49%,与所有内镜医师相比均具有相当大的优势,无论使用 WLI 还是 NBI (P < 0.001)。CADx 的辅助作用显著提高了内镜医师的诊断准确率,从 68.84%提高到 77.49%(P = 0.001),对新手内镜医师的影响最为显著。值得注意的是,使用 CADx 辅助 WLI 的新手内镜医师的表现优于没有这种辅助的初级和专家内镜医师。
CADx 在显著提高 WLI 下结直肠息肉光学诊断的准确性方面发挥了关键作用,对新手内镜医师具有最大的辅助作用。