A deep learning based smartphone application for early detection of nasopharyngeal carcinoma using endoscopic images.

Nasal endoscopy is crucial for the early detection of nasopharyngeal carcinoma (NPC), but its accuracy relies heavily on the clinician's expertise, posing challenges for primary healthcare providers. Here, we retrospectively analysed 39,340 nasal endoscopic white-light images from three high-incidence NPC centres, utilising eight advanced deep learning models to develop an Internet-enabled smartphone application, "Nose-Keeper", that can be used for early detection of NPC and five prevalent nasal diseases and assessment of healthy individuals. Our app demonstrated a remarkable overall accuracy of 92.27% (95% Confidence Interval (CI): 90.66%-93.61%). Notably, its sensitivity and specificity in NPC detection achieved 96.39% and 99.91%, respectively, outperforming nine experienced otolaryngologists. Explainable artificial intelligence was employed to highlight key lesion areas, improving Nose-Keeper's decision-making accuracy and safety. Nose-Keeper can assist primary healthcare providers in diagnosing NPC and common nasal diseases efficiently, offering a valuable resource for people in high-incidence NPC regions to manage nasal cavity health effectively.