Computer-Aided Diagnosis Improves Characterization of Barrett's Neoplasia by General Endoscopists
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND & AIMS
Characterization of visible abnormalities in Barrett esophagus (BE) patients can be challenging, especially for unexperienced endoscopists. This results in suboptimal diagnostic accuracy and poor inter-observer agreement. Computer-aided diagnosis (CADx) systems may assist endoscopists. We aimed to develop, validate and benchmark a CADx system for BE neoplasia.
METHODS
The CADx system received pretraining with ImageNet with consecutive domain-specific pretraining with GastroNet which includes 5 million endoscopic images. It was subsequently trained and internally validated using 1,758 narrow-band imaging (NBI) images of early BE neoplasia (352 patients) and 1,838 NBI images of non-dysplastic BE (173 patients) from 8 international centers. CADx was tested prospectively on corresponding image and video test sets with 30 cases (20 patients) of BE neoplasia and 60 cases (31 patients) of non-dysplastic BE. The test set was benchmarked by 44 general endoscopists in two phases (phase 1: no CADx assistance; phase 2: with CADx assistance). Ten international BE experts provided additional benchmark performance.
RESULTS
Stand-alone sensitivity and specificity of the CADx system were 100% and 98% for images and 93% and 96% for videos, respectively. CADx outperformed general endoscopists without CADx assistance in terms of sensitivity (p=0.04). Sensitivity and specificity of general endoscopist increased from 84% to 96% and 90 to 98% with CAD assistance (p<0.001), respectively. CADx assistance increased endoscopists' confidence in characterization (p<0.001). CADx performance was similar to Barrett experts.
CONCLUSION
CADx assistance significantly increased characterization performance of BE neoplasia by general endoscopists to the level of expert endoscopists. The use of this CADx system may thereby improve daily Barrett surveillance.
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Additional Info
COMPUTER-AIDED DIAGNOSIS IMPROVES CHARACTERIZATION OF BARRETT'S NEOPLASIA BY GENERAL ENDOSCOPISTS
Gastrointest. Endosc. 2024 Apr 16;[EPub Ahead of Print], JB Jukema, CHJ Kusters, MR Jong, KN Fockens, T Boers, JA van der Putten, RE Pouw, LC Duits, BAM Weusten, LA Herrero, MHMG Houben, WB Nagengast, J Westerhof, A Alkhalaf, R Mallant-Hent, P Scholten, K Ragunath, S Seewald, P Elbe, FB Silva, M Barret, JO Fernández-Sordo, GM Villarejo, O Pech, T Beyna, NSM Montazeri, F van der Sommen, PH de With, AJ de Groof, JJ BergmanFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.