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Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions

Background and Objectives: Device-assisted enteroscopy (DAE) has a significant role in approaching enteric lesions. Endoscopic observation of ulcers or erosions is frequent and can be associated with many nosological entities, namely Crohn’s disease. Although the application of artificial intelligen...

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Autores principales: Martins, Miguel, Mascarenhas, Miguel, Afonso, João, Ribeiro, Tiago, Cardoso, Pedro, Mendes, Francisco, Cardoso, Hélder, Andrade, Patrícia, Ferreira, João, Macedo, Guilherme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865285/
https://www.ncbi.nlm.nih.gov/pubmed/36676796
http://dx.doi.org/10.3390/medicina59010172
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author Martins, Miguel
Mascarenhas, Miguel
Afonso, João
Ribeiro, Tiago
Cardoso, Pedro
Mendes, Francisco
Cardoso, Hélder
Andrade, Patrícia
Ferreira, João
Macedo, Guilherme
author_facet Martins, Miguel
Mascarenhas, Miguel
Afonso, João
Ribeiro, Tiago
Cardoso, Pedro
Mendes, Francisco
Cardoso, Hélder
Andrade, Patrícia
Ferreira, João
Macedo, Guilherme
author_sort Martins, Miguel
collection PubMed
description Background and Objectives: Device-assisted enteroscopy (DAE) has a significant role in approaching enteric lesions. Endoscopic observation of ulcers or erosions is frequent and can be associated with many nosological entities, namely Crohn’s disease. Although the application of artificial intelligence (AI) is growing exponentially in various imaged-based gastroenterology procedures, there is still a lack of evidence of the AI technical feasibility and clinical applicability of DAE. This study aimed to develop and test a multi-brand convolutional neural network (CNN)-based algorithm for automatically detecting ulcers and erosions in DAE. Materials and Methods: A unicentric retrospective study was conducted for the development of a CNN, based on a total of 250 DAE exams. A total of 6772 images were used, of which 678 were considered ulcers or erosions after double-validation. Data were divided into a training and a validation set, the latter being used for the performance assessment of the model. Our primary outcome measures were sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and an area under the curve precision–recall curve (AUC-PR). Results: Sensitivity, specificity, PPV, and NPV were respectively 88.5%, 99.7%, 96.4%, and 98.9%. The algorithm’s accuracy was 98.7%. The AUC-PR was 1.00. The CNN processed 293.6 frames per second, enabling AI live application in a real-life clinical setting in DAE. Conclusion: To the best of our knowledge, this is the first study regarding the automatic multi-brand panendoscopic detection of ulcers and erosions throughout the digestive tract during DAE, overcoming a relevant interoperability challenge. Our results highlight that using a CNN to detect this type of lesion is associated with high overall accuracy. The development of binary CNN for automatically detecting clinically relevant endoscopic findings and assessing endoscopic inflammatory activity are relevant steps toward AI application in digestive endoscopy, particularly for panendoscopic evaluation.
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spelling pubmed-98652852023-01-22 Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions Martins, Miguel Mascarenhas, Miguel Afonso, João Ribeiro, Tiago Cardoso, Pedro Mendes, Francisco Cardoso, Hélder Andrade, Patrícia Ferreira, João Macedo, Guilherme Medicina (Kaunas) Article Background and Objectives: Device-assisted enteroscopy (DAE) has a significant role in approaching enteric lesions. Endoscopic observation of ulcers or erosions is frequent and can be associated with many nosological entities, namely Crohn’s disease. Although the application of artificial intelligence (AI) is growing exponentially in various imaged-based gastroenterology procedures, there is still a lack of evidence of the AI technical feasibility and clinical applicability of DAE. This study aimed to develop and test a multi-brand convolutional neural network (CNN)-based algorithm for automatically detecting ulcers and erosions in DAE. Materials and Methods: A unicentric retrospective study was conducted for the development of a CNN, based on a total of 250 DAE exams. A total of 6772 images were used, of which 678 were considered ulcers or erosions after double-validation. Data were divided into a training and a validation set, the latter being used for the performance assessment of the model. Our primary outcome measures were sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and an area under the curve precision–recall curve (AUC-PR). Results: Sensitivity, specificity, PPV, and NPV were respectively 88.5%, 99.7%, 96.4%, and 98.9%. The algorithm’s accuracy was 98.7%. The AUC-PR was 1.00. The CNN processed 293.6 frames per second, enabling AI live application in a real-life clinical setting in DAE. Conclusion: To the best of our knowledge, this is the first study regarding the automatic multi-brand panendoscopic detection of ulcers and erosions throughout the digestive tract during DAE, overcoming a relevant interoperability challenge. Our results highlight that using a CNN to detect this type of lesion is associated with high overall accuracy. The development of binary CNN for automatically detecting clinically relevant endoscopic findings and assessing endoscopic inflammatory activity are relevant steps toward AI application in digestive endoscopy, particularly for panendoscopic evaluation. MDPI 2023-01-15 /pmc/articles/PMC9865285/ /pubmed/36676796 http://dx.doi.org/10.3390/medicina59010172 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martins, Miguel
Mascarenhas, Miguel
Afonso, João
Ribeiro, Tiago
Cardoso, Pedro
Mendes, Francisco
Cardoso, Hélder
Andrade, Patrícia
Ferreira, João
Macedo, Guilherme
Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title_full Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title_fullStr Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title_full_unstemmed Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title_short Deep-Learning and Device-Assisted Enteroscopy: Automatic Panendoscopic Detection of Ulcers and Erosions
title_sort deep-learning and device-assisted enteroscopy: automatic panendoscopic detection of ulcers and erosions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9865285/
https://www.ncbi.nlm.nih.gov/pubmed/36676796
http://dx.doi.org/10.3390/medicina59010172
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