A real-time deep learning-based system for colorectal polyp size estimation by white-light endoscopy: development and multicenter prospective validation

医学 大肠息肉 内窥镜 一致性 虚拟大肠镜 结肠镜检查 结直肠癌 前瞻性队列研究 内窥镜检查 息肉切除术 人工智能 放射科 内科学 计算机科学 癌症
作者
Jing Wang,Ying Li,Shuyu Li,Honggang Yu,Boru Chen,Cheng Du,Fei Liao,Tao Tan,Qinghong Xu,Zhifeng Liu,Yuan Huang,Ci Zhu,Wenbing Cao,Liwen Yao,Zhifeng Wu,Lianlian Wu,Chenxia Zhang,Bing Xiao,Ming Xu,Jun Li
出处
期刊:Endoscopy [Thieme Medical Publishers (Germany)]
卷期号:56 (04): 260-270 被引量:14
标识
DOI:10.1055/a-2189-7036
摘要

Abstract Background The choice of polypectomy device and surveillance intervals for colorectal polyps are primarily decided by polyp size. We developed a deep learning-based system (ENDOANGEL-CPS) to estimate colorectal polyp size in real time. Methods ENDOANGEL-CPS calculates polyp size by estimating the distance from the endoscope lens to the polyp using the parameters of the lens. The depth estimator network was developed on 7297 images from five virtually produced colon videos and tested on 730 images from seven virtual colon videos. The performance of the system was first evaluated in nine videos of a simulated colon with polyps attached, then tested in 157 real-world prospective videos from three hospitals, with the outcomes compared with that of nine endoscopists over 69 videos. Inappropriate surveillance recommendations caused by incorrect estimation of polyp size were also analyzed. Results The relative error of depth estimation was 11.3% (SD 6.0%) in successive virtual colon images. The concordance correlation coefficients (CCCs) between system estimation and ground truth were 0.89 and 0.93 in images of a simulated colon and multicenter videos of 157 polyps. The mean CCC of ENDOANGEL-CPS surpassed all endoscopists (0.89 vs. 0.41 [SD 0.29]; P<0.001). The relative accuracy of ENDOANGEL-CPS was significantly higher than that of endoscopists (89.9% vs. 54.7%; P<0.001). Regarding inappropriate surveillance recommendations, the system's error rate is also lower than that of endoscopists (1.5% vs. 16.6%; P<0.001). Conclusions ENDOANGEL-CPS could potentially improve the accuracy of colorectal polyp size measurements and size-based surveillance intervals.
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